Occult optic disc pit: Clinical observations and multimodal imaging correlates

This study highlights the diagnostic difficulty and multimodal imaging clues in a case of occult optic disc pit maculopathy (ODP-M) without visible optic disc anomalies. We report a case of occult disc pit and the role of multimodal multoimodal imaging for its diagnosis. A 28-year-old male previously diagnosed as amblyopic in the right eye presented with decreased vision. Fundus examination showed subtle peripapillary hyperpigmentation and faint macular pigmentary changes. Although the initial impression suggested central serous chorioretinopathy, discrepancies in optic disc size and peripapillary alterations raised suspicion for an occult disc pit. Enhanced depth imaging optical coherence tomography (OCT) revealed temporal optic nerve head cavitations with a focal breach in the tissue, confirming occult ODP. Macular OCT demonstrated ellipsoid zone and external limiting membrane disruption without schisis cavities. Occult ODP-M is easily misdiagnosed without a high index of suspicion. Dense raster OCT and optic disc radial scans are crucial for early recognition and appropriate management.