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Peer-reviewedCC BY-NCCase reports in ophthalmology

Occult Optic Disk Pit Maculopathy Masquerading as Exudative Age-Related Macular Degeneration in an Elderly Patient: A Case Report.

  • Aaron T Zhao1
  • Sonny Caplash2
  • Benjamin J Kim2
  1. 1Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
  2. 2Department of Ophthalmology, Scheie Eye Institute, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
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Abstract

Occult optic disk pit maculopathy (ODPM) is a rare cause of macular retinoschisis in which no pit is visible on funduscopic examination. Optic disk pits are congenital cavitary anomalies thought to arise from incomplete closure of the embryonic fissure during ocular development. This report presents an 83-year-old woman with a history of exudative AMD of the left eye (OS) and low-tension glaucoma having received 11 intravitreal anti-VEGF injections over approximately 18 months without resolution of macular fluid. Fluorescein angiography demonstrated no macular leakage and no macular neovascularization. Spectral-domain optical coherence tomography revealed multilayered peripapillary retinoschisis with fluid extending from the optic disk to the fovea. Dedicated optic disk OCT confirmed a deep crater-like excavation consistent with an occult optic disk pit. Anti-VEGF therapy was discontinued, and the patient was observed. At approximately 10 months after the last injection, best-corrected visual acuity was stable at 20/25 OS with stable nasal macular cysts on OCT. Occult ODPM can closely mimic exudative AMD and may go unrecognized for many months in elderly patients with coexisting retinal disease, resulting in repeated unnecessary anti-VEGF treatment.

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Cite

BibTeXRIS
BibTeX
@article{zhao2026occult,
  title = {{Occult Optic Disk Pit Maculopathy Masquerading as Exudative Age-Related Macular Degeneration in an Elderly Patient: A Case Report.}},
  author = {Aaron T Zhao and Sonny Caplash and Benjamin J Kim},
  journal = {Case reports in ophthalmology},
  year = {2026},
  month = oct,
  doi = {10.1159/cop/acaag013},
  url = {https://europepmc.org/article/MED/42953591},
  note = {CC BY-NC},
}
RIS
TY  - JOUR
TI  - Occult Optic Disk Pit Maculopathy Masquerading as Exudative Age-Related Macular Degeneration in an Elderly Patient: A Case Report.
AU  - Aaron T Zhao
AU  - Sonny Caplash
AU  - Benjamin J Kim
PY  - 2026
DA  - 2026/10/16
JO  - Case reports in ophthalmology
DO  - 10.1159/cop/acaag013
UR  - https://europepmc.org/article/MED/42953591
AB  - Occult optic disk pit maculopathy (ODPM) is a rare cause of macular retinoschisis in which no pit is visible on funduscopic examination. Optic disk pits are congenital cavitary anomalies thought to arise from incomplete closure of the embryonic fissure during ocular development. This report presents an 83-year-old woman with a history of exudative AMD of the left eye (OS) and low-tension glaucoma having received 11 intravitreal anti-VEGF injections over approximately 18 months without resolution of macular fluid. Fluorescein angiography demonstrated no macular leakage and no macular neovascularization. Spectral-domain optical coherence tomography revealed multilayered peripapillary retinoschisis with fluid extending from the optic disk to the fovea. Dedicated optic disk OCT confirmed a deep crater-like excavation consistent with an occult optic disk pit. Anti-VEGF therapy was discontinued, and the patient was observed. At approximately 10 months after the last injection, best-corrected visual acuity was stable at 20/25 OS with stable nasal macular cysts on OCT. Occult ODPM can closely mimic exudative AMD and may go unrecognized for many months in elderly patients with coexisting retinal disease, resulting in repeated unnecessary anti-VEGF treatment.
SN  - 1663-2699
ER  -