Abstract

PurposeTo evaluate the anatomical and visual outcomes in optic disc pit maculopathy following pars plana vitrectomy (PPV) with inverted internal limiting membrane (ILM) flapMethodsRetrospective interventional case series of 10 patients diagnosed with serous macular detachment secondary to optic disc pit who underwent PPV with inverted ILM flap and were followed up for a year.ResultsA p-value of less than 0.05 was defined as statistically significant. The mean age of patients was 27.2 ± 10.6 years, preoperatively the mean best-corrected visual acuity of the logarithm of the minimum angle of resolution was 0.91 ± 0.42 (approximate Snellen equivalent 20/162), which improved to the logarithm of the minimum angle of resolution of 0.58 ± 0.29 (approximate Snellen equivalent 20/76) at end of one year, (p=0.008). The mean central macular thickness was 804.9 ± 294.1 m which improved to 273.4 ± 102.54 m, (p=0.002). After surgery, at end of one year, 60% of patients (6/10) had 15- or more-than-15-letter improvement of vision on Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity testing, 20% (2/10) gained a 10-letter improvement and 20% (2/10) retained the same vision.ConclusionPPV with inverted ILM flap can be considered as a good approach for the management of serous macular detachment secondary to optic disc pit and produce good anatomical and visual results at one year with stabilization of the disease.

Highlights

  • Optic disc pit (ODP) is a rare congenital anomaly of the optic nerve head (ONH) appearing as a small hypopigmented grey-white depression usually located in the temporal part of the optic disc [1]

  • The mean age of patients was 27.2 ± 10.6 years, preoperatively the mean best-corrected visual acuity of the logarithm of the minimum angle of resolution was 0.91 ± 0.42, which improved to the logarithm of the minimum angle of resolution of 0.58 ± 0.29 at end of one year, (p=0.008)

  • ODP-related maculopathy (ODPM) is characterized by the presence of retinal schisis and serous macular detachment (SMD) [5,6,7]

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Summary

Introduction

Optic disc pit (ODP) is a rare congenital anomaly of the optic nerve head (ONH) appearing as a small hypopigmented grey-white depression usually located in the temporal part of the optic disc [1]. ODPs are usually asymptomatic, 25-75% of cases present with defective vision if associated with ODP-related maculopathy (ODPM) [2, 4]. ODPM is characterized by the presence of retinal schisis and serous macular detachment (SMD) [5,6,7]. Other retinal findings in long-standing ODPM include cystoid macular edema (CME), lamellar macular holes (LMH), full-thickness macular hole (FTMH), and retinal pigment epithelium (RPE) atrophy, which is usually associated with a poor visual acuity of 20/200 or worse [8,9,10]. The exact pathogenic mechanism of ODPM remains unclear, it has been proposed that vitreous or cerebrospinal fluid (CSF) may be the origin of the fluid [11,12,13]

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