Automated evaluation of parapapillary choroidal microvasculature in crowded optic discs:a controlled,optical coherence tomography angiography study

AIM:To compare superficial and deep vascular properties of optic discs between crowded discs and controls using optical coherence tomography angiography(OCT-A).METHODS:Thirty patients with crowded discs,and 47 control subjects were enrolled in the study.One eye of each individual was included and OCT-A scans of optic discs were obtained in a 4.5×4.5 mm^(2) rectangular area.Radial peripapillary capillary(RPC)density,peripapillary retinal nerve fiber layer(pRNFL)thickness,cup volume,rim area,disc area,cup-to-disc(c/d)area ratio,and vertical c/d ratio were obtained automatically using device software.Automated parapapillary choroidal microvasculature(PPCMv)density was calculated using MATLAB software.When the vertical c/d ratio of the optic disc was absent or small cup,it was considered as a crowded disc.RESULTS:The mean signal strength index of OCT-A images was similar between the crowded discs and control eyes(P=0.740).There was no difference in pRNFL between the two groups(P=0.102).There were no differences in RPC density in whole image(P=0.826)and peripapillary region(P=0.923),but inside disc RPC density was higher in crowded optic discs(P=0.003).The PPCMv density in the inner-hemisuperior region was also lower in crowded discs(P=0.026).The pRNFL thickness was positively correlated with peripapillary RPC density(r=0.498,P<0.001).The inside disc RPC density was negatively correlated with c/d area ratio(r=-0.341,P=0.002).CONCLUSION:The higher inside disc RPC density and lower inner-hemisuperior PPCMv density are found in eyes with crowded optic discs.

An Improved Deep Learning Framework for Automated Optic Disc Localization and Glaucoma Detection

Glaucoma disease causes irreversible damage to the optical nerve and it has the potential to cause permanent loss of vision.Glaucoma ranks as the second most prevalent cause of permanent blindness.Traditional glaucoma diagnosis requires a highly experienced specialist,costly equipment,and a lengthy wait time.For automatic glaucoma detection,state-of-the-art glaucoma detection methods include a segmentation-based method to calculate the cup-to-disc ratio.Other methods include multi-label segmentation networks and learning-based methods and rely on hand-crafted features.Localizing the optic disc(OD)is one of the key features in retinal images for detecting retinal diseases,especially for glaucoma disease detection.The approach presented in this study is based on deep classifiers for OD segmentation and glaucoma detection.First,the optic disc detection process is based on object detection using a Mask Region-Based Convolutional Neural Network(Mask-RCNN).The OD detection task was validated using the Dice score,intersection over union,and accuracy metrics.The OD region is then fed into the second stage for glaucoma detection.Therefore,considering only the OD area for glaucoma detection will reduce the number of classification artifacts by limiting the assessment to the optic disc area.For this task,VGG-16(Visual Geometry Group),Resnet-18(Residual Network),and Inception-v3 were pre-trained and fine-tuned.We also used the Support Vector Machine Classifier.The feature-based method uses region content features obtained by Histogram of Oriented Gradients(HOG)and Gabor Filters.The final decision is based on weighted fusion.A comparison of the obtained results from all classification approaches is provided.Classification metrics including accuracy and ROC curve are compared for each classification method.The novelty of this research project is the integration of automatic OD detection and glaucoma diagnosis in a global method.Moreover,the fusion-based decision system uses the glaucoma detection result obtained using several convolutional deep neural networks and the support vector machine classifier.These classification methods contribute to producing robust classification results.This method was evaluated using well-known retinal images available for research work and a combined dataset including retinal images with and without pathology.The performance of the models was tested on two public datasets and a combined dataset and was compared to similar research.The research findings show the potential of this methodology in the early detection of glaucoma,which will reduce diagnosis time and increase detection efficiency.The glaucoma assessment achieves about 98%accuracy in the classification rate,which is close to and even higher than that of state-of-the-art methods.The designed detection model may be used in telemedicine,healthcare,and computer-aided diagnosis systems.

Refined Anam-Net:Lightweight Deep Learning Model for Improved Segmentation Performance of Optic Cup and Disc for Glaucoma Diagnosis

In this work,we aim to introduce some modifications to the Anam-Net deep neural network(DNN)model for segmenting optic cup(OC)and optic disc(OD)in retinal fundus images to estimate the cup-to-disc ratio(CDR).The CDR is a reliable measure for the early diagnosis of Glaucoma.In this study,we developed a lightweight DNN model for OC and OD segmentation in retinal fundus images.Our DNN model is based on modifications to Anam-Net,incorporating an anamorphic depth embedding block.To reduce computational complexity,we employ a fixed filter size for all convolution layers in the encoder and decoder stages as the network deepens.This modification significantly reduces the number of trainable parameters,making the model lightweight and suitable for resource-constrained applications.We evaluate the performance of the developed model using two publicly available retinal image databases,namely RIM-ONE and Drishti-GS.The results demonstrate promising OC segmentation performance across most standard evaluation metrics while achieving analogous results for OD segmentation.We used two retinal fundus image databases named RIM-ONE and Drishti-GS that contained 159 images and 101 retinal images,respectively.For OD segmentation using the RIM-ONE we obtain an f1-score(F1),Jaccard coefficient(JC),and overlapping error(OE)of 0.950,0.9219,and 0.0781,respectively.Similarly,for OC segmentation using the same databases,we achieve scores of 0.8481(F1),0.7428(JC),and 0.2572(OE).Based on these experimental results and the significantly lower number of trainable parameters,we conclude that the developed model is highly suitable for the early diagnosis of glaucoma by accurately estimating the CDR.

Clinical characteristics of peripapillary hyperreflective ovoid mass-like structures in myopic children

AIM:To describe the characteristics of peripapillary hyperreflective ovoid mass-like structure(PHOMS)in myopic children and to investigate factors associated with PHOMS.METHODS:This retrospective observational study included 101 eyes of 101 children(age≤17y)with myopia.All included patients underwent comprehensive clinical examination.Optic nerve canal parameters,including disc diameter,optic nerve head(ONH)tilt angle,and border tissue angle were measured using serial enhanced-depth imaging spectral-domain optical coherence tomography(EDI-OCT).Based on the optic disc drusen consortium’s definition of PHOMS,eyes were classified as PHOMS group and non-PHOMS group.PHOMS was categorized according to height.RESULTS:Sixty-seven(66.3%)eyes were found with PHOMS.Small PHOMS could only be detected by optical coherence tomography(OCT).Medium PHOMS could be seen with blurred optic disc borders corresponding to OCT.The most frequent location of PHOMS was at the nasosuperior(91%,61 of 67 eyes)to ONH disc.The axial length and spherical equivalent were more myopic in the PHOMS group than in the non-PHOMS group(both P<0.001).ONH tilt angle was also significantly greater in PHOMS group than in non-PHOMS group[8.90(7.16-10.54)vs 3.93(3.09-5.25),P<0.001].Border tissue angle was significantly smaller in PHOMS group than in non-PHOMS group[29.70(20.90-43.81)vs 45.62(35.18-60.45),P<0.001].In the multivariable analysis,spherical equivalent(OR=3.246,95%CI=1.209-8.718,P=0.019)and ONH tilt angle(OR=3.275,95%CI=1.422-7.542,P=0.005)were significantly correlated with PHOMS.There was no disc diameter associated with PHOMS.In the linear regression analysis,border tissue angle was negatively associated with PHOMS height(β=-2.227,P<0.001).CONCLUSION:PHOMS is associated with optic disc tilt and optic disc nasal shift in myopia.Disc diameter is not a risk factor for PHOMS.The changes in ONH caused by axial elongation facilitated an understanding of the mechanism of PHOMS.

Birth Defects of the Child Optic Disc: Diagnostic Challenges and Prospects for Care

Introduction: Congenital optic disc anomalies in children refer to structural variations of the optic nerve head present from birth. These deformations involve the size, shape, color, and vessels of the optic disc. Although often asymptomatic, these anomalies can impact the visual development of the child, underscoring the importance of a thorough fundus examination for early detection and appropriate medical follow-up. We present two cases of congenital optic disc anomalies in children, illustrating the diagnostic challenges and complexity of their management. Case 1: A 3-year-old girl presented with a white spot in her left eye present since birth. Uncorrected distance visual acuity was 2/10 in the right eye, while she could perceive hand movements at 2 meters with the left eye. Normal examination in the right eye showed leukocoria, microphthalmia, and a white mass at the center of the optic disc on fundus examination in the left eye. Ocular imaging, including ultrasound and optical coherence tomography (OCT), confirmed the diagnosis of persistent hyperplastic primary vitreous (PHPV) in its mixed form in the left eye. Management included prescribing full optical correction and functional rehabilitation, without resorting to surgery. The course was marked by persistent amblyopia leading to a poor prognosis. Case 2: A 7-year-old girl consulted for vision disturbance in her right eye. Visual acuity was finger counting at 2 meters in the right eye and 10/10 in the left eye. Anterior segment examination revealed no abnormalities in both eyes. However, fundus examination highlighted a large funnel-shaped excavation associated with central glial proliferation, wheel spoke vessels, and neuroretinal ring atrophy in the right eye. Optical coherence tomography (OCT) of the right eye confirmed the diagnosis of isolated unilateral Morning Glory syndrome. Management included full optical correction and orthoptic rehabilitation. The course was marked by the absence of ocular complication and maintenance of visual stability in the right eye. The prognosis seemed favorable. Conclusion: Congenital optic disc anomalies in children exhibit great clinical variability and require an individualized diagnostic and therapeutic approach.

Late Diagnosis of Congenital Optic Disc Abnormalities

Purpose: To show epidemiological and imaging aspects of congenital optic disc abnormalities diagnosed late. Method: It was a retrospective study, including all patients with congenital optic disc abnormalities diagnosed at a late age between January 2020 and October 2022 at the eye center of Abass Ndao Hospital. Complete ophthalmological examination was performed with eye imaging according to the cases. Results: 09 patients (10 eyes) were diagnosed with congenital optic disc abnormalities. The mean age was 29 years, with a sex ratio of 0.8. Three patients had consulted for unilateral decreased visual acuity since childhood, two for sudden vision loss and in four cases the diagnosis was fortuitous. Visual acuity was ranged from 1/200 to 20/20. Fundus examination showed myelinated retinal nerve fibers in four eyes, optic disc pit in three eyes including two complicated by maculopathy, two cases of morning glory syndrome and a case of pseudoduplication of the optic disc. Optical coherence tomography, ocular ultrasound B and OCT-Angiography were performed according to the cases. Conclusion: Congenital optic disc abnormalities are often diagnosed late. They are potentially amblyogenic and complications are not rare, worsening the visual prognosis. Their screening should be systematic by ophthalmological examination in newborns.

Second Approximation Model for Optical Head in Super High Density Storage Technology

The paper presents second approximation model for optical head in super high-density storage technology firstly and it is an important part for three grades approximate model of ultra-small-size quantum well corn-shaped laser and simulative calculations. It supplies the important and useful results for the NFOD optical head design with ultra thin active layer and ultra small spot laser.

SCANNING TUNNELING MICROSCOPY STUDIES ON OPTICAL DISC

Scanning tunneling microscope (STM) is used to investigate the optical disc.The areas with and without data stampers are all observed carefully. Three-dimensional images of the disc surface clearly demonstrate the period, depth of the grooves and the shape of data stampers. Some phenomena of STM imaging are also discussed.

Overview of optical coherence tomography in neuro-ophthalmology

Optical coherence tomography(OCT)is a widely used non-invasive medical imaging technology that has revolutionized clinical care in ophthalmology.New developments,such as OCT angiography(OCTA)are expected to contribute even further to the widespread use of OCT-based imaging devices in the diagnosis and monitoring of patients with ophthalmic diseases.In recent years,many of the disadvantages such as limited field of view and imaging artefacts have been substantially reduced.Similar to the progress achieved in the assessment of retinal disorders,OCT is expected to change the approach to patients seen in the neuro-ophthalmology clinic.In this article,we review the technical features of OCT and OCT-based imaging techniques,highlighting the specific factors that should be taken into account when interpreting OCT in the field of neuro-ophthalmology.

The role of optical coherence tomography in neuro-ophthalmology

Optical coherence tomography(OCT)is an ocular imaging technique that can complement the neuro-ophthalmic assessment,and inform our understanding regarding functional consequences of neuroaxonal injury in the afferent visual pathway.Indeed,OCT has emerged as a surrogate end-point in the diagnosis and follow up of several demyelinating syndromes of the central nervous system(CNS),including optic neuritis(ON)associated with:multiple sclerosis(MS),neuromyelitis optica spectrum disorder(NMOSD),and anti-myelin oligodendrocyte glycoprotein(MOG)antibodies.Recent advancements in enhanced depth imaging(EDI)OCT have distinguished this technique as a new gold standard in the diagnosis of optic disc drusen(ODD).Moreover,OCT may enhance our ability to distinguish cases of papilledema from pseudopapilledema caused by ODD.In the setting of idiopathic intracranial hypertension(IIH),OCT has shown benefit in tracking responses to treatment,with respect to reduced retinal nerve fiber layer(RNFL)measures and morphological changes in the angling of Bruch’s membrane.Longitudinal follow up of OCT measured ganglion cell-inner plexiform layer thickness may be of particular value in managing IIH patients who have secondary optic atrophy.Causes of compressive optic neuropathies may be readily diagnosed with OCT,even in the absence of overt visual field defects.Furthermore,OCT values may offer some prognostic value in predicting post-operative outcomes in these patients.Finally,OCT can be indispensable in differentiating optic neuropathies from retinal diseases in patients presenting with vision loss,and an unrevealing fundus examination.In this review,our over-arching goal is to highlight the potential role of OCT,as an ancillary investigation,in the diagnosis and management of various optic nerve disorders.

Quantitative analysis of optic disc changes in school-age children with ametropia based on artificial intelligence

AIM:To explore changes in the optic disc and peripapillary atrophy(PPA)in school-age children with ametropia using color fundus photography combined with artificial intelligence(AI)technology.METHODS:Based on the retrospective case-controlled study,226 eyes of 113 children aged aged 6–12y were enrolled from October 2021 to May 2022.According to the results of spherical equivalent(SE),the children were divided into four groups:low myopia group(66 eyes),moderate myopia group(60 eyes),high myopia group(50 eyes)and emmetropia control group(50 eyes).All subjects underwent un-aided visual acuity,dilated pupil optometry,best-corrected visual acuity(BCVA),intraocular pressure,ocular axis measurement and color fundus photography.RESULTS:The width of PPA,horizontal diameter ratio of PPA to the optic disc and area ratio of PPA to the optic disc were significantly different among the four groups(P<0.05).The width of the nasal and temporal neuroretinal rim,the roundness of the optic disc,the height of PPA,the vertical diameter ratio of PPA to the optic disc,and the average density of PPA in the high myopia group were significantly different compared with the other three groups(P<0.05).There were strong negative correlations between SE and area ratio of PPA to the optic disc(r=-0.812,P<0.001)and strong positive correlation between axial length(AL)and area ratio of PPA to the optic disc(r=0.736,P<0.001).CONCLUSION:In school-age children with high myopia,the nasal and temporal neuroretinal rims are narrowed and even lost,which have high sensitivity.The area ratio of the PPA to the optic disc could be used as an early predictor of myopia progression,which is of great significance for the development prevention and management of myopia.

Quantitative study of peripapillary retinal nerve fiber layer thickness and peripapillary vessel density in patients with different stages of Parkinson's disease

AIM: To observe the changes in the thickness of peripapillary retinal nerve fiber layer(p RNFL) and peripapillary vessel density(pVD) in patients with different stages of Parkinson's disease(PD).METHODS: Totally 47 patients(47 eyes) with primary PD were divided into the mild group and the moderateto-severe group according to Hoehn & Yahr(H&Y) stage. Among them, there were 27 cases(27 eyes) in mild group and 20 cases(20 eyes) in moderate-to-severe group. And 20 cases(20 eyes) who were included in the control group were healthy people who came to our hospital for health screening at the same time. All participants underwent optical coherence tomography angiography(OCTA) examinations. The pRNFL thickness, total vessel density(tVD) and capillary vessel density(cVD) of the optic disc in average, superior half, inferior half, superior nasal(SN), nasal superior(NS), nasal inferior(NI), inferior nasal(IN), inferior temporal(IT), temporal inferior(TI), temporal superior(TS), and superior temporal(ST) were measured. One-way ANOVA was used to compare the differences of optic disc parameters among the three groups, and Pearson and Spearman correlations were used to analyze the correlation between pRNFL, pVD and the disease duration, H&Y stage and UPDRS-Ⅲ score in patients with PD, respectively.RESULTS: There were significant differences in p RNFL thickness in average, superior half, inferior half, SN, NS, IN, IT and ST quadrants among the three groups(P<0.05). In PD group, the pRNFL thickness in average, superior half, inferior half, NS and IT quadrants were negatively correlated with H&Y stage and UPDRS-Ⅲ score, respectively(P<0.05). There were statistically significant differences in the cVD of whole image, inferior half, NI and TS quadrants, the tVD of the whole image, inferior half, and peripapillary among the three groups(P<0.05). In PD group, the tVD of whole image and the c VD of NI and TS quadrants were negatively correlated with the H&Y stage, respectively(P<0.05);the cVD of TS quadrant was negatively correlated with UPDRS-Ⅲ score(P<0.05).CONCLUSION: The thickness of pRNFL in PD patients is significantly decreased, and it is negatively correlated with H&Y stage and UPDRS-Ⅲ score. With the increase of the severity of the disease, the pVD parameters in PD patients increase at first in the mild group, and then decrease in the moderate-to-severe group, and negatively correlate with H&Y stage and UPDRS-Ⅲ score.

Automatic Optic Disc Detection in Retinal Images Using FKMT‒MOPDF

In recent days,detecting Optic Disc(OD)in retinal images has been challenging and very important to the early diagnosis of eye diseases.The process of detecting the OD is challenging due to the diversity of color,intensity,brightness and shape of the OD.Moreover,the color similarities of the neighboring organs of the OD create difficulties during OD detection.In the proposed Fuzzy K‒Means Threshold(FKMT)and Morphological Operation with Pixel Density Feature(MOPDF),the input retinal images are coarsely segmented by fuzzy K‒means clustering and thresholding,in which the OD is classified from its neighboring organs with intensity similarities.Then,the segmented images are given as the input to morphological operation with pixel density feature calculations,which reduce the false detection in the small pixel of the OD.Finally,the OD area is detected by applying the Sobel edge detection method,which accurately detects the OD from the retinal images.After detection optimization,the proposed method achieved Sensitivity(SEN),Specificity(SPEC)and Accuracy(ACC),with 96.74%,96.78%and 96.92%in DiaretDB0(Standard Diabetic Retinopathy Database Calibration level 0),97.12%,97.10%and 97.75%in DiaretDB1(Standard Diabetic Retinopathy Database Calibration level 1)and 97.19%,97.47%and 97.43%in STARE(Structured Analysis of the Retina)dataset respectively.The experimental results demonstrated the proposed method’s efficiency for segmenting and detecting OD areas.

Optic disc and peripapillary changes by optic coherence tomography in high myopia

Myopia,a worldwide condition,is a multifactorial disease resulting in many ocular complications.Early onset of myopia has a great tendency to develop high myopia and pathological myopia later in life.The pathophysiology and progression of myopia is still unclear.Owing to its involving in visual function,optic disc and peripapillary change in high myopia can＇t be neglected,and it may help in better understanding of the pathophysiology or mechanism of myopia progression.Recently,advanced imaging techniques have been developed,such as optical coherence tomography（OCT）,allowing for better detecting of optic disc and peripapillary change.OCT is a highresolution and noninvasive measurement for detection of ocular structure.Herein,we provide an updated review of optic disc and peripapillary change in OCT image,including its characteristics and clinical significance.We also propose some problems needed further investigation.

Peripapillary retinal nerve fibre layer thickness measurement with SD-OCT in normal and glaucomatous eyes:distribution and correlation with age

AIMTo determine peripapillary retinal fiber layer thickness (RNFL) measured with spectral domain optical coherence tomography (SD-OCT) in normal and glaucomatous eyes in a large sample of exclusively white population and compare results with other similarly constructed studies.

Optic disc area in different types of glaucoma

AIMTo evaluate the possible relationship of optic disc area with retina nerve fiber layer in different glaucoma subtypes.METHODSOne eye each was chosen from 45 patients with ocular hypertension, 45 patients with primary open angle glaucoma, 45 patients with pseudoexfoliation glaucoma and 45 healthy controls followed in our hospital. The records of the patients were reviewed retrospectively. Optic disc area and circumpapillary retina nerve fiber layer measurements were obtained using optical coherence tomography. Central corneal thickness was measured by ultrasound pachymetry.RESULTSThe median disc area in the patients with primary open angle glaucoma was significantly higher than the patients with ocular hypertension (2.19 vs 1.90 mm2, P=0.030). The median retina nerve fiber layer was thinner in the patients with primary open angle glaucoma and pseudoexfoliation glaucoma than the patients with ocular hypertension for superior, inferior and temporal quadrants. After adjustment for age, no difference in central corneal thickness was found between the groups. Greater disc area was associated with thicker retinal nerve fiber layer for superior, inferior and nasal quadrants in the patients with primary open angle glaucoma. There was no correlation between disc area and central corneal thickness measurements of the groups.CONCLUSIONDisc size affects the retinal nerve fiber layer thickness in eyes with primary open angle glaucoma and is a possible risk factor for glaucomatous optic nerve damage.

Commentary review on peripapillary morphological characteristics in high myopia eyes with glaucoma:diagnostic challenges and strategies

The incidences of open angle glaucoma(OAG)and high myopia are increasing concomitantly.Considering the aging population and concurrent rapid increase in the number of individuals with myopia,the risk of visual defects caused by highly myopic OAG is likely to increase dramatically over the next few decades.However,precise screening and diagnosis of OAG is challenging because of the tilt and rotation of the optic disc,as well as extensiveβ-zone parapapillary atrophy in highly myopic eyes.Recent advances in optical coherence tomography(OCT)and OCT angiography(OCTA)technologies imply that both modalities are promising tools for the detection of highly myopic OAG.Notably,the diagnosis of OAG remains to be determined with the longitudinal changes of functional damages(e.g.visual field defect,visual electrophysiological changes).We herein describe some aspects of microvascular and microstructural pathology in patients with highly myopic OAG and proposes a framework for the development of novel diagnostic and therapeutic strategies.

Relationship between short-wavelength automatic perimetry and Heidelberg retina tomograph parameters in eyes with ocular hypertension

AIMTo compare and correlate optic nerve head parameters obtained by Heidelberg retina tomograph (HRT) with short-wavelength automatic perimetry (SWAP) indices in eyes with ocular hypertension (OHT).METHODSOne hundred and forty-six patients with OHT included in the present study. All subjects had reliable SWAP and HRT measurements performed within a 2wk period. The eyes were classified as normal/abnormal according to visual field criteria and Moorfields regression analysis (MRA). Correlations between visual field indices and HRT parameters were analyzed using Pearson correlation coefficient (r).RESULTSTwenty-nine eyes (19.9%) had SWAP defects. Twenty-nine eyes (19.9%) were classified as abnormal according to global MRA. Six eyes (4.1%) had abnormal global MRA and SWAP defects. The k statistic is 0.116 (P=0.12) indicating a very poor agreement between the methods. No statistical significant correlation between HRT and SWAP parameters was detected.CONCLUSIONSWAP defects may coexist with abnormalities of optic disc detected by HRT in eyes with OHT. In most eyes, however, the two methods detect different glaucoma properties.

NDC-IVM:An automatic segmentation of optic disc and cup region from medical images for glaucoma detection

Glaucoma is an eye disease that usually occurs with the increased Intra-Ocular Pressure(IOP),which damages the vision of eyes.So,detecting and classifying Glaucoma is an important and demanding task in recent days.For this purpose,some of the clustering and segmentation techniques are proposed in the existing works.But,it has some drawbacks that include ineficient,inaccurate and estimates only the affected area.In order to solve these issues,a Neighboring Differential Clustering(NDC)-Intensity V ariation Making(IVM)are proposed in this paper.The main intention of this work is to extract and diagnose the abnormal retinal image by identifying the optic disc.This work includes three stages such as,preprocessing,clustering and segmentation.At first,the given retinal image is preprocessed by using the Gaussian Mask Updated(GMU)model for eliminating the noise and improving the quality of the image.Then,the cluster is formed by extracting the threshold and patterns with the help of NDC technique.In the segmentation stage,the weight is calculated for pixel matching and ROI extraction by using the proposed IVM method.Here,the novelty is presented in the clustering and segmentation processes by developing NDC and IVM algorithms for accurate Glaucoma identification.In experiments,the results of both existing and proposed techniques are evaluated in terms of sensitivity,specificity,accuracy,Hausdorff distance,Jaccard and dice metrics.

Serous macular detachment due to nasally located optic disc pit-coloboma

Dear Editor,We present the first reported case of nasal optic disc pit resulting in serous detachment of the macula. Optic disc pit is a rare congenital anomaly occurring in one out of 11 000 people. The appearance is a localized round or oval depression in that is grey, yellow or black in colour depending on the amount of glial tissue present.