Abstract
A patient presented with a 26-month history of gradually worsening blurry vision in the right eye. The past ocular history was significant for intermediate uveitis in the right eye 3 years earlier, which responded well to an oral prednisone taper. The workup for intermediate uveitis was negative, including HLA-B27, FTA-ABS, ACE, lysozyme, QuantiFERON-TB Gold, and chest radiography. At presentation, visual acuity was 20/150 in the right eye and 20/25 in the left eye. Ocular examination revealed mild cataracts and bilateral epiretinal membranes, as well as a Bergmeister papilla in the right eye. Notably, no optic disc pit was clinically visible. OCT demonstrated macular edema nasally associated with an epiretinal membrane in the right eye, while the left eye showed an epiretinal membrane without macular edema. The patient underwent pars plana vitrectomy, epiretinal membrane/internal limiting membrane peeling, peripapillary endolaser, and gas tamponade in the right eye. During surgery, the surgeon performed repeated aspiration of fluid through the optic disc, despite the absence of a clinically visible optic disc pit. The origin of the fluid and the precise mechanism underlying optic disc pit formation remain controversial. Proposed sources of fluid include vitreous fluid, cerebrospinal fluid, and leakage from retinal or optic disc blood vessels. One month after surgery, the macular edema had completely resolved; however, visual acuity remained unchanged. This case suggests that an occult optic disc pit has contributed to the development of maculopathy.
Presentation Date: 09/17/2026
Issue Date: 09/18/2026
