Optic disc pit maculopathy presents insidiously, with the congenital communication between the pit and the subretinal space creating a slow, progressive accumulation of fluid within the outer retinal layers, often mimicking central serous chorioretinopathy on cursory examination. The surgical objective here was twofold: eliminate the fluid source and restore foveal architecture. Fovea-sparing ILM peeling was performed with deliberate intent, the ILM peeled circumferentially while preserving the foveal ILM to protect the underlying Muller cell architecture and maintain structural integrity at the foveal center. The critical step was pit stuffing, directly tamponading the optic disc pit to obliterate the communication between the pit and the subretinal space. C3F8 was chosen over SF6 for its prolonged tamponade duration, allowing adequate time for chorioretinal adhesion, ILM edge apposition, and foveal reattachment. Foveal architecture restored. Subretinal fluid resolved. The pit, sealed.
