Abstract
Congenital optic disc pit is a rare finding that develops from incomplete closure of the embryonic choroid fissure. Maculopathy is a major cause of visual deterioration. The treatment of the macular detachments associated with congenital optic disc pits remains controversial however it is emphasized that rerouting fluid from subretinal space may be efficient method. Main drawback of commonly use surgical methods is slow reabsorption of fluid taking weeks or even months. We report a different surgical approach in 2 patients consisting of vitrectomy, subretinal tissue glue injection followed by gas tamponade that allowed achieving very fast functional and anatomic recovery within 1 month.
Highlights
Congenital optic disc pit is rare finding that develops from incomplete closure of the embryonic choroid fissure
Our report of 2 cases presents different surgical approach consisting of vitrectomy with aspiration of subretinal fluid and subretinal tissue glue injection followed by SF6 gas tamponade that allowed achieving dramatic functional and anatomic improvement within 1 month
We think that presented technique realizes the thesis of rerouting fluid from subretinal space arresting the subretinal fluid influx efficiently and making macula reattach within very short period of time
Summary
Congenital optic disc pit is rare finding that develops from incomplete closure of the embryonic choroid fissure. Retinal detachment observed in 50%-75% of cases may involve the passage of vitreous fluid to the subretinal space. Our report of 2 cases presents different surgical approach consisting of vitrectomy with aspiration of subretinal fluid and subretinal tissue glue injection followed by SF6 gas tamponade that allowed achieving dramatic functional and anatomic improvement within 1 month. After 2 weeks of follow up the visual acuity gained to 0.7 with residual; small portion of subretinal fluid located extrafovealy (Figure 4). There was a small, temporal inferiorly located congenital optic disc pit and macular detachment. In SOCT images herniated dysplastic retina connected with posterior vitreous traction, retinoschisis and macular detachment was observed (Figures 6a, 6b and 6c). Three weeks after PPV with subretinal tissue glue injection patient presented 0.9 visual acuity with only residual subretinal fluid left temporally that eventually disappeared 2 weeks later. Three weeks after PPV with subretinal tissue glue injection patient presented 0.9 visual acuity with only residual subretinal fluid left temporally that eventually disappeared 2 weeks later. (Figures 7 and 8) There is no anatomical and functional changes; in both cases in 2 years follow up
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