tation and can include laser ablation, surgical excision, orobservation.

Poster 17

Congenital Optic Nerve Pit Masquerading as GlaucomaAlison Palmer, O.D., and David Bejot, O.D., The EyeCenter of Toledo, 3000 Regency Ct., Suite 100, Toledo,Ohio 43623

Background: Congenital optic pits are an optic discanomaly thought to be a variant of an optic nervecoloboma. They typically are unilateral and most com-monly found in the inferotemporal quadrant. Temporallylocated optic pits have an increased risk for serousmacular detachments that can lead to a lamellar hole. Thepresentation can lead to an abnormal C/D appearance,which can falsely suggest glaucomatous damage. Alsomaking the diagnosis difficult is the accompanying visualfield that, although variable, is often an arcuate or aparacentral scotoma. This defect is thought to result froma loss of the retinal ganglion cells or a secondary atrophyof neural tissue from the depressed pit. Congenital opticpits are often pigmented, have well-defined borders, andaverage one third of a disc diameter in size. Congenitalpits must be differentiated from acquired pits that are thedirect result of glaucomatous damage. Visual field de-fects associated with congenital optic pits should notworsen with time, whereas progression is expected withacquired pits. Acquired pits, although similar in position,are not pigmented and are not associated with serousdetachments.Case Summary: A 66-year-old white woman was referredto The Eye Center of Toledo for a glaucoma evaluation.She reported no systemic conditions. Best-corrected vi-sual acuity yielded 20/30 O.D. and 20/25 O.S. Pertinentocular history included radial keratotomy OU in 1992,and uncomplicated cataract surgery OU in 2007. Pastrecords from 2 other optometrists labelled her as aglaucoma suspect because of C/D asymmetry. Previousrecords indicated an IOP range of 11 mmHg to 17 mmHgOU, and no family history of glaucoma was reported. HerIOP at this visit was 16 mmHg O.D. and 14 mmHg O.S.Pachymetry readings were .542 O.D. and .546 O.S.Anterior segment findings were positive for trace poste-rior capsular haze OU. Dilated retinal examination wasunremarkable except for a noted C/D asymmetry of0.3H/0.5V O.D. and 0.3 O.S. A Humphrey 24-2 visualfield revealed a superior paracentral defect O.D. and wasunremarkable O.S. OCT testing was performed and re-vealed thinning in the inferior part of the right retinalnerve fiber layer.Conclusion: This patient was found to have a small opticpit in her right eye that mimicked glaucoma in terms ofvertical elongation and defects seen with visual field andOCT testing. When the classic risk factors of glaucomalike intraocular pressures, pachymetry, family history,

OCT, and visual field results were taken into account, itseemed likely that the optic pit was masquerading asglaucoma in this case. She was educated on the conditionand the likeliness that her OCT and visual field resultsshould remain constant over time, something that onewould expect to progress and worsen if a glaucomatouscondition were present. Patients with the initial diagnosisof optic pits should be kept on 6-month re-evaluationsthat include a dilated fundus examination, intraocularpressure measurement, and auxiliary testing, which mayinclude optic disc photos. Patients should be educated onhome Amsler grid use and signs and symptoms of mac-ular pathology.

Poster 18

End-Stage Acute Retinal Necrosis in a Young PatientWith History of Herpes Simplex Virus EncephalitisSanjeet K. Shahi, O.D., and Ryan K. Patel, O.D., LakeCity VAMC, 619 South Marion, Lake City, Florida 32025

Background: Besifloxacin is a novel fluoroquinolone beinginvestigated for the topical treatment of bacterial conjunc-tivitis (BC). The objective of this study was to compare theclinical and microbial efficacy of besifloxacin with that ofvehicle alone in the treatment of BC. Two definitions forclinical resolution were explored.Methods: This was a multicenter, randomized, double-masked, parallel group study. Adults and children 1 year ofage and older with clinical manifestations of BC wererandomized to besifloxacin (n�137) or vehicle (n�132)instilled 3 times daily for 5 days. Ocular signs and symp-toms, visual acuity (VA), and biomicroscopy were assessedand cultures were taken at visits 1 (day 1), 2 (days 3-5), and3 (day 8 or 9). Ophthalmoscopy was conducted at visits 1and 3. The primary efficacy endpoints were clinical resolu-tion and eradication of baseline bacterial infection at visit 3in subjects with culture-confirmed conjunctivitis. Safetymeasures included adverse events (AEs), VA changes,biomicroscopy evaluations and ophthalmoscopy.Results: Clinical resolution—defined as the absence ofconjunctival discharge, bulbar conjunctival injection, andpalpebral conjunctival injection—was observed in 61.7%(37/60) vs. 35.7% (20/56) of subjects randomized to besi-floxacin and vehicle, respectively, at visit 3 (P�0.0013),and 23.3% (14/60) vs. 14.3% (8/56) of subjects randomizedto besifloxacin and vehicle, respectively, at visit 2(P�0.3144). Applying the definition of clinical resolutionmore commonly used in the literature (which excludespalpebral conjunctival injection from the above definition),clinical resolution was observed in 73.3% (44/60) vs. 46.4%(26/56) of subjects randomized to besifloxacin and vehicle,respectively, at visit 3 (P�0.0019), and 33.3% (20/60) vs.17.9% (20/56) of subjects randomized to besifloxacin andvehicle, respectively, at visit 2 (P�0.1090). The proportionof subjects randomized to besifloxacin experiencing clinicalresolution was similar to that reported in subjects treated

307Poster Presentations