Optic Disc Pit-associated Maculopathy Research Articles

Optic Disc Pit Maculopathy: A Case Report

Optic disc pit is a rare congenital abnormality. This disorder can be associated with serous maculopathy which results on a visual deterioration. Pathophysiology of this maculopathy remains unknown and it appears in the third or fourth decade. There is no consensus in treatment of optic disc pit-associated maculopathy. In this article, we will report a case of an optic disc pit maculopathy in a 31 years old Moroccan patient treated with PPV.

Management of optic disc pit-associated maculopathy: A case series from a tertiary referral center.

To report outcomes of pars plana vitrectomy (PPV) combined with internal limiting membrane (ILM) stuffing technique in patients with optic disc pit associated maculopathy (ODP-M). Data including best-corrected visual acuity (BCVA), central macular thickness (CMT), foveal center point thickness (FCP), and maximum height of fluid (max_fluid) (intraretinal or subretinal) were collected from the medical records of the patients. Six eyes of six patients with a mean age of 28.0 ± 17.68 years (range: 9-53 year) underwent PPV + ILM plug surgery. The mean follow-up duration was 25.62 ± 26.11 months (range: 11.80-78.00 month) duration. The mean BCVA increased from 1.25 ± 1.04 logMAR (20/355, Snellen equivalent) to 0.86 ± 1.09 logMAR (20/144, Snellen equivalent) at last follow-up (p = 0.043). Compared to baseline, CMT, FCP, and max_fluid significantly decreased at all visits after the surgery (p < 0.05 for all visits). At last follow-up, 66.6% of the eyes (four eyes) showed complete resolution of fluid at a mean of 5.25 ± 4.99 months (range: 1-12 months) after the surgery. PPV with ILM plug seemed to be an effective surgical technique in ODP-M. Studies with longer follow-up and higher number of patients are needed to confirm our results.

The characteristics of optic disc pit maculopathy and the efficacy of vitrectomy: a systematic review and meta-analysis.

To evaluate the basic characteristics of optic disc pit maculopathy (ODPM) and the efficacies of pars plana vitrectomy (PPV) treatment with different adjunctive strategies. The databases PubMed, EMBASE and Ovid up to April 2020 were searched to identify relevant studies. Statistical analyses were conducted with R software version 3.6.3. Fifty-nine studies were eventually included for different aspects of statistical analyses. The pooling results suggest the general incidence of maculopathy in optic disc pit (ODP) is 51%, and the rate of serous macular detachment and retinoschisis is 49% and 58%, respectively. The incidence of sub-retinal fluid (SRF) only is 10%, intra-retinal retinal (IRF) fluid only is 14%, and SRF plus IRF is 69%. A lamellar macular hole (LMH) is present in 53% of cases, and 58% have communication between the macula with the pit. The incidence of posterior vitreous detachment (PVD), vitreo-papillary traction and vitreomacular traction (VMT) is 7%, 28% and 13%, respectively. Besides, the rate of complete anatomic success and visual improvement after PPV are both around 85%. Subgroup analysis reveals the anatomic, and visual success rates of PPV alone are 89% and 100%, respectively. Gas tamponade, laser or internal limiting membrane peeling (ILMP) during vitrectomy are less promising, while PPV with ILM flap stuffing could achieve better outcomes than cases without it. Optic disc pit-associated maculopathy has different fundus characteristics. Based on the current evidence, PPV is effective for ODPM, and the combined application of gas tamponade, laser and ILMP should be used with caution.

Intraoperative optical coherence tomography findings during surgery for optic disc pit-associated maculopathy.

Intraoperative optical coherence tomography findings during surgery for optic disc pit-associated maculopathy.

Swept-Source OCT and Swept-Source OCT Angiography before and after Vitrectomy with Stuffing of the Optic Pit

To identify swept-source (SS) OCT and SS OCT angiography (OCTA) patterns predicting outcome in patients with optic disc pit-associated maculopathy and to present the results of a novel surgical technique, stuffing of the optic disc pit. Prospective, interventional study. Fifteen eyes. Swept-source OCT before surgery and then 1 week and 1, 3, and 6 months after surgery, then up to 4 years later. Swept-source OCTA was performed from 2015 (9 patients). After core vitrectomy, internal limiting membrane (ILM) was peeled between the optic nerve and fovea and stuffed into the optic disc pit. Laser photocoagulation was performed at the temporal side of the optic disc pit. Fluid-air exchange followed. The following data were noted: visual acuity, central retinal thickness, distribution of fluid on SS OCT, and diameters and circuit of the foveal avascular zone on OCTA. Normalization of the fovea contour and visual acuity. We subdivided patients into 2 groups. On SS OCT, we observed subretinal fluid with elevation of the fovea (group 1) in 8 eyes. Group 2 comprised 7 eyes without subretinal fluid, but with intraretinal fluid. Five of these eyes additionally showed an outer lamellar macular hole. Anatomic success was achieved in all eyes. The decrease of central retinal thickness 1 week after surgery was more marked in group 1 (P = 0.002). The area of the foveal avascular zone in the superficial retinal vessel layer increased significantly after surgery for group 2 (P= 0.04), but not for group 1 (P= 0.4). Visual acuity improved without statistically significant differences between groups. Stuffing of the optic disc pit with the ILM results in improvement of anatomic and functional results. Prognosis depends on initial morphologic features. Central retinal thickness normalizes faster after surgery in eyes with subretinal fluid when compared with eyes with intraretinal fluid. Faster anatomic improvement does not correlate with improvement of vision. Postoperative increase in the size of the foveal avascular zone in the superficial retinal vessel layer, more pronounced in group 2, may be associated with the prolonged postoperative anatomic recovery in those eyes.

The results of 25-gauge vitreoretinal surgery for optic disc pit-associated maculopathy: a report of three cases and mini-review of the literature

We report the outcomes of three consecutive patients with optic disc pit-associated maculopathy who were treated with 25-gauge pars plana vitrectomy, internal limiting membrane (ILM) peeling, fluid-air exchange, barrage endolaser, and sulfur hexafluoride (SF6) gas tamponade. Patients with optic disc pit-associated maculopathy were treated with 25-gauge pars plana vitrectomy followed by ILM peeling, fluid-air exchange, barrage endolaser, and gas tamponade with 20% SF6. All patients were asked to maintain a facedown position for 3days postoperatively. This technique resulted in complete retinal reattachment after 25-gauge vitrectomy, ILM peeling, fluid-air exchange, barrage endolaser, and 20% SF6 gas injection. The best-corrected visual acuity (BCVA) improved in all three patients and successful anatomical results were achieved. There wasn't any macular detachment in all cases at 20th week follow-up. Our outcomes suggest that 25-gauge vitrectomy with ILM peeling, fluid-air exchange, barrage endolaser, and SF6 gas tamponade appears to be an effective treatment option for optic disc pit-associated maculopathy.

Vitrectomy for optic disc pit-associated maculopathy with or without preoperative posterior vitreous detachment

BackgroundThe purpose of this study was to evaluate the efficacy of pars plana vitrectomy for the treatment of optic disc pit-associated maculopathy with or without preoperative posterior vitreous detachment.MethodsWe reviewed the clinical records of four consecutive patients who underwent pars plana vitrectomy in one eye for the treatment of optic disc pit-associated maculopathy, with an emphasis on the preoperative condition of the posterior hyaloid membrane.ResultsTwo of four eyes were confirmed to have an attached posterior hyaloid membrane, which was subsequently removed during surgery. Following vitrectomy, these two eyes experienced an improvement in visual acuity with complete retinal attachment of the macula. However, the other two eyes, which already had a posterior vitreous detachment at the time of surgery, showed a decrease in visual acuity with persistent maculopathy postoperatively.ConclusionPars plana vitrectomy for optic disc pit-associated maculopathy was beneficial for improving visual acuity in two eyes without preoperative posterior vitreous detachment but not in two eyes with preoperative posterior vitreous detachment. Our study suggests that preoperative assessment of a posterior hyaloid membrane is clinically important in predicting the surgical outcome of optic disc pit-associated maculopathy.

Autofluorescence and optical coherence tomography findings in optic disc pit-associated maculopathy: case series

The aim of this case series was to report and discuss the clinical, fundus autofluorescence (FAF), and optical coherence tomography (OCT) findings of four eyes of three cases with optic disc pit (ODP)-related serous macular detachment. Three cases were referred to the retina department of our hospital for decreased visual acuities in four of their eyes. In addition to ophthalmological examinations, OCT and FAF were also performed. ODP-related serous macular detachment was detected clinically in all the eyes. OCT also showed two typical components named as 'bilaminar structure' in all eyes and OCT and FAF photography showed precipitates in the retinal outer layers of the detachment area in three eyes. OCT and autofluorescence photography findings can support clinical observations in the diagnosis of ODP-related maculopathy.

Drainage of subretinal fluid in optic disc pit maculopathy using subretinal 42-gauge cannula: a new surgical approach

Different surgical approaches have been used for the treatment of optic disc pit associated maculopathy, with increasing emphasis on vitrectomy. Case report We report a case of optic disc pit maculopathy where vitrectomy was combined with subretinal fluid drainage using a 42-gauge subretinal cannula connected to a "back-flush" flute handle. No retinopexy was performed at the site of drainage. This technique resulted in almost complete resolution of subretinal fluid by 6 weeks, with visual acuity improving from 1.00 Log MAR preoperatively to 0.40 at 8 months after surgery. We describe a novel technique for subretinal fluid drainage using a subretinal 42-G cannula connected to a standard "back flush" flute in optic disc pit-associated maculopathy.