Treating Acquired Optic Disc Pit Maculopathy with an Ocular Hypotensive Agent

Abstract

Purpose: To describe a case of glaucomatous optic disc pit maculopathy that resolved after bimatoprost treatment. Observations: A 63-year-old African American female with a history of type 2 diabetes mellitus presented to the clinic after 3 months of blurry vision in the right eye and was found to have an asymmetric cup-to-disc ratio, and right intraretinal and subretinal fluid without leakage on fluorescein angiography concerning for optic disc pit maculopathy. A trial of intravitreal anti-vascular endothelial growth factor (VEGF) injection failed to resolve the fluid. Optical coherence tomography of the ganglion cell complex showed thinning of the ganglion cell complex concerning for previously undiagnosed glaucoma, and the patient was started on bimatoprost. The previously noted fluid resolved, and the patient has been quiescent for 4 years on ocular hypotensive medication. Conclusion: In untreated or poorly controlled glaucoma, progressive cupping of the optic nerve head may lead to the development of an acquired optic disc pit, which can produce maculopathy. This maculopathy can improve under ocular hypotensive treatment.