Case ReportOPTIC DISK PIT ASSOCIATED WITH AN UNUSUAL OUTER RETINAL HOLE AND NASAL PERIPHERAL RETINOSCHISISCorvi, Federico MD*,†,‡; Nguyen, Tieu Vy MD†; Juhn, Alexander MD†; Corradetti, Giulia MD*,†; Al-Sheikh, Mayss MD§; Zweifel, Sandrine A. MD§; Sadda, SriniVas R. MD*,† Author Information *Doheny Eye Institute, University of California at Los Angeles, Los Angeles, California; †Stein Eye Institute, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles; ‡Department of Biomedical and Clinical Science “Luigi Sacco,” Eye Clinic, Sacco Hospital, University of Milan, Milan, Italy; and §Department of Ophthalmology, University Hospital Zurich, University of Zurich, Zurich, Switzerland. Reprint requests: SriniVas R. Sadda, MD, Department of Ophthalmology, Doheny Eye Institute, David Geffen School of Medicine at UCLA, 1355 San Pablo Street, Los Angeles, CA 90033; e-mail: [email protected] S. A. Zweifel: (C) Allergan, (C, F) Bayer, (C, F) Novartis; S. R. Sadda: Amgen (C), Allergan (C), Genentech-Roche (C), Oxurion (C), Novartis (C), Regeneron (C), Bayer (C), 4DMT (C), Centervue (C, S), Heidelberg (C, F, S), Optos (C, F, S), Carl Zeiss Meditec (F, S), Nidek (S), Topcon (S). None of the other authors has any financial/conflicting interests to disclose. All authors attest that they meet the current ICMJE criteria for authorship. Retinal Cases & Brief Reports 17(1):p 1-4, January 2023. | DOI: 10.1097/ICB.0000000000001110 Buy Metrics AbstractIn Brief Purpose: To document a peculiar case of optic disk pit-associated maculopathy with extensive nasal retinoschisis with lamellar outer retinal hole. Methods: A 41-year-old woman presented to the eye clinic complaining of new photopsias and enlargement of the blind spot in the left eye. Uncorrected visual acuity was 20/20 in both eyes. Fundus examination of the left eye revealed an anomalous appearing optic nerve with a gray oval depression at the temporal margin of the disk consistent with an optic disk pit. Results: Optical coherence tomography confirmed the presence of the pit and demonstrated outer plexiform layer schisis superonasal to the fovea and extensive inner and outer retinal schisis nasal to the nerve extending to the equator. A large lamellar outer retinal hole was noted nasal to the disk without associated retinal detachment. The vitreous appeared to be attached over the nasal retina. Conclusion: Multimodal imaging revealed an unusual optic disk pit-associated retinopathy with dramatically more extensive retinoschisis and a lamellar outer retinal hole nasal to the nerve despite the temporal location of the pit. Although the precise pathophysiologic mechanisms are not fully understood, forces associated with the vitreo-retinal adhesion may have contributed to the distribution of the schisis in this case. In this case, we observed an unusual extensive retinoschisis and a lamellar outer retinal hole nasal to the nerve despite the temporal location of the optic disk pit. The vitreo-retinal adhesion may have contributed to the distribution of the schisis in this case.