Perforation of Presumed Papillary Gliosis Resulting in an Optic Pit in a Child

A healthy 16-month-old boy had a translucent, gliotic-appearing membrane overlying the left optic nerve. Grayish discoloration was apparent inferotemporally (Figure, A). By age 8 years, the presumed gliosis had thinned to a translucent, pulsatile membrane. One year later, the membrane had perforated (Figure, B). An adjacent papillomacular nerve fiber layer defect was evident, associated with visual acuity of 20/70 OS. There was no subretinal fluid on optical coherence tomography.