The prevalence in this group is estimated to be less than 0.1 percent, compared with at least 1.5 percent in adolescents. Symptoms in older patients may be less intense than in younger patients and may be combined with cognitive dysfunction. Mania has been associated with cerebrovascular lesions of the right hemisphere and orbitofrontal areas, steroid therapy, trauma to the head and some forms of dementia. No specific trials of therapy have been conducted in elderly persons, so treatment is based on studies of younger patients. Disturbances in the development of the epithelial papilla can result in the formation of an optic nerve pit.
Pits are usually unilateral, appearing as gray lesions within the optic disc.
They may be associated with visual field defects and symptoms similar to those of glaucoma. Serous retinal detachment develops in the macular area in approximately one half of patients with optic pits. In fewer than 20 percent of these patients, the detachments spontaneously reattach. Diverticulae and associated hypertrophy of the bowel musculature are believed to result from disordered peristalsis. The prevalence of diverticulosis in Westerners is thought to be related to a diet low in fiber.