Optic Pit Research Articles

Triple trouble: Bilateral advanced glaucoma with optic disc pit and myopic maculopathy

Triple trouble: Bilateral advanced glaucoma with optic disc pit and myopic maculopathy

Vitreoretinal surgery in difficult cases

In the everyday practice, we are dealing with various level of difficulty, while performing vitreoretinal cases. There are some cases which require high level of skills and experience in order to perform successful and effective surgery. Refractory or myopic macular holes, optic disk pit cases, PVR cases, advanced proliferative diabetic retinopathy cases, trauma cases and paediatric vitreoretinal cases are some examples. The purpose of the SIS is a group of very experienced vitreoretinal surgeons with high volume of cases, to provide tips and pearls in to how to perform safer surgery, with the best results, anatomically and functionally. We will also provide advise into how to use chandelier additional lighting and how to use and remove heavy silicone oil and buckles.

Results of treatment of optic disc pit maculopathy in children

Purpose: to analyze the anatomical and functional results of the differentiated treatment of optic disc pit maculopathy in children.Material and methods. We examined 23 children aged 5–17 years with an o ptic disc pit maculopathy. 10 children underwent retinal laser coagulation (LC) along the borders of the optic disc pit (1–3 sessions), 13 children underwent pars plana vitrectomy with gas tamponade (C2F6) in combination with retinal LC. In addition to the standard ophthalmological examination, all children underwent optical coherence tomography of the macular area of the retina before treatment and at different times after it.Results. In the group of children who underwent LC, the initial value of the maximum retina elevation averaged 525 ± 140 μm (from 346 to 882 μm). After laser treatment, all children showed a decrease in retinal elevation by 32 to 602 μm. 3 children had complete resorption of subretinal fluid during follow-up periods from 5 to 13 months. Best corrected visual acuity (BCVA) remained stable in 5 children, increased by 0.04–0.6 in 4 children, and decreased by 0.1 in one child. In the group of surgically treated children, the elevation of the retina before the intervention averaged 919 ± 143 μm (from 614 to 1420 μm) (p < 0.05). After the intervention, this parameter decreased in all children by 91 to 811 μm, complete resorption of subretinal fluid was observed in 4 children during follow-up periods from 4 to 6 months. BCVA remained stable in 5 children, increased in 7 children by 0.1–0.7, and decreased by 0.4 in one child due to the progression of the cataract.Conclusion. The differentiated approach to the treatment of optic disc pit maculopathy in children proved to be highly efficient, depending on the height of retinal elevation in the macular zone before the start of treatment.

OPTIC DISK PIT STUFFING-TO DO OR NOT TO DO.

Optic disk pit (ODP) is a subset of spectrum of congenital cavitary anomalies. Optic disk pit maculopathy causes progressive visual deterioration and is addressed with pars plana vitrectomy (PPV) with or without ODP stuffing. We report a case of progressive ODP maculopathy who was taken up for 23-G 3-port PPV, with complete vitreous removal and stuffing of the ODP with autologous sclera and sequential analysis of change in the retinal nerve fiber layer (RNFL) thickness. Spectral-domain optical coherence tomography RNFL analysis at 1 and 12 months follow-up postoperatively showed total RNFL thickness decrease from 130 µm to 103 µm respectively. Hemiquadrant analysis showed slight reduction of superior RNFL thickness from 142 µm to 139 µm. However, in the inferior hemiquadrant, the reduction in mean RNFL thickness seems to be significant from 133 µm to 100 µm at 1 and 12 months respectively. Sector-wise analysis of the RNFL thickness showed maximum reduction in the inferotemporal quadrant and other sectors seemed to be relatively preserved corresponding to the area of scleral stuffing. Retrospective or prospective analysis of RNFL health of patients undergoing surgery for ODP-M with stuffing needs to evaluated.

Congenital versus acquired optic disc pit maculopathy: An OCT based study.

The purpose of this study is to describe and compare the demographic, ocular, and imaging characteristics of a cohort of patients with congenital and acquired optic disc pit maculopathy (ODPM). This retrospective case series included patients diagnosed with ODPM between June 2017 and April 2023. These patients' baseline demographics, ocular characteristics, and optical coherence tomography (OCT) imaging characteristics and follow up changes were analyzed. A total of 14 eyes with ODPM were identified (9 congenital and 5 acquired). Eyes with congenital ODP developed maculopathy at a younger age, presented commonly with visual symptoms, and exhibited an obvious pit at the temporal foveal margin as well as a high cup: disc ratio (p < 0.05). Primary open-angle glaucoma was identified in all five eyes with acquired ODPM. On OCT, eyes with acquired ODPM lacked the characteristic nerve fibre layer schisis, outer retinal layer hole, and foveal serous macular detachment (p < 0.05) unlike congenital ODPM. At the final follow-up visit, two cases from the congenital ODPM group and one case from the acquired ODPM group displayed complete resolution of maculopathy. The two cases of congenital ODPM were treated with pars plana vitrectomy and laser barrage to the optic disc margin, while the solitary case of acquired ODPM was treated with trabeculectomy surgery alone. Clinical examination and baseline OCT imaging reveal distinct differences between congenital and acquired ODPM eyes. These characteristics may help with accurate diagnosis and treatment planning for these two distinct clinical entities.

Development of Acquired Peripapillary Optic Disk Pit in Pathologic Myopia.

Development of Acquired Peripapillary Optic Disk Pit in Pathologic Myopia.

Optic pit maculopathy: incidence and clinical course

The aim of this case series was to investigate the clinical course of patients with optic pit maculopathy. The medical records of all patients diagnosed with optic pit maculopathy in the past 10years were reviewed. Optic pit maculopathy was diagnosed when localized intraretinal or/and subretinal fluid spread from the optic nerve to the macula. Outcome measures included changes in best corrected visual acuity (BCVA), central retinal thickness (RT) as well as nasal parafoveal and perifoveal RT. An optic disc pit was detected in 18patients (9female, 9male, mean age: 33 ± 23years). Retinal fluid accumulation was present in 6(33.3%) of the patients (1intraretinal, 1subretinal, 4intraretinal and subretinal). Pars plana vitrectomy with removal of peripapillary vitreous traction and peeling of the internal limiting membrane (ILM) was indicated in 5patients and was performed in 4patients. One patient underwent nanopulse laser treatment instead. The patients with optic pit maculopathy were 47 ± 16years old. In this group of patients, mean BCVA (decimal) improved from 0.3 ± 0.2 before treatment to 0.5 ± 0.2 3months after treatment (p = 0.03). Visual acuity improved in all patients with optic disc pit maculopathy after pars plana vitrectomy. The mean central RT decreased from 796 ± 214 before treatment to 324 ± 57 3months after treatment (p = 0.005). The mean nasal parafoveal RT decreased from 683 ± 87 before treatment to 372 ± 41 (p = 0.0003) and the mean nasal perifoveal RT decreased from 547 ± 89 before treatment to 360 ± 48 (p = 0.007). Acompletely dry macula was achieved in 4eyes after amean follow-up of 3months. At long-term follow-up (2.5 ± 1.2years), no recurrence occurred in the vitrectomized eyes. This case series showed that more than one third of the patients had optic pit maculopathy presumably caused by disruption of the Kuhnt intermediate tissue. Interventional treatment was indicated in all cases, of which 4were surgically treated and resulted in significant improvement of function and anatomical retinal structures.

Application progress of human amniotic membrane in vitreoretinopathy: a literature review.

Recently, the application of the amniotic membrane (AM) in ophthalmology is gradually expanding from the anterior to the posterior segment of the eye. Its characteristics of anti-inflammation, anti-bacterial, anti-vascularization, immune regulation, anti-fibrosis, pro-epithelialization, and so forth have made it a hot topic in ophthalmic research. AM has been confirmed to repair photoreceptors, restore normal retinal structures, and close the abnormal structures in the optic disc. Currently, the application areas mainly include retinal hole, retinal detachment, optic disc pit, retinal degenerative diseases, and choroidal hole. This article reviews the current literature applying AM transplantation in the treatment of various posterior segment diseases while comparing the clinical outcomes with other techniques.

A unique case of bilateral nanophthalmos and pigmentary retinal abnormality with unilateral angle closure glaucoma and optic disc pit

BackgroundMicroophthalmos or ‘dwarf eye’ is characterized by an axial length 2 standard deviation less than age-matched controls. It is classified into nanophthalmos, relative anterior microphthalmos, and posterior microphthalmos based on the anterior segment: posterior segment ratio. Nanophthalmos can occur in association with optic disc drusen, foveoschisis, and retinitis pigmentosa, as an autosomal recessive syndrome linked to mutations in the MFRP gene. We report a case of bilateral nanophthalmos and pigmentary retinopathy with angle closure glaucoma and optic disc pit in one eye. We believe this to be the first case presenting with optic disc pit in association with nanophthalmos.Case presentationA 56-year-old female presented with bilateral small eyes, high hypermetropia, shallow anterior chamber depth, increased lens thickness, mid-peripheral retinal flecks, and macular edema. She also had high intraocular pressure in the right eye, with a disc cupping of 0.9 with an Optic disc pit. The macular edema in the right eye was found to occur in association with the Optic disc pit, whereas, in the left eye, it was associated with intra-retinal hemorrhages and diagnosed as macular branch retinal vein occlusion secondary to hypertension. She was started on anti-glaucoma medications in both eyes and planned for Anti-VEGF injection in the left eye.ConclusionThis case report is unique as it reports an association of Nanophthalmos with Optic Disc pit, with an associated angle closure glaucoma in the same eye, an association which has never been previously reported in the literature.

Minimally invasive procedure for optic disc pit maculopathy: vitrectomy with scleral plug and analysis on pattern of resolution

Optic disc pit maculopathy (ODP-M) is a rare complication of optic disc pit which can cause irreversible visual impairment. The aim of this study is to evaluate the anatomical and functional outcomes and pattern of resolution of ODP-M following vitrectomy with posterior vitreous detachment (PVD) induction and scleral tissue plug for treatment of ODP-M without ILM peeling, laser or use of long term gas/tamponade or head positioning. This retrospective study included 7 patients with ODP-M, meeting the inclusion criteria. Patients were followed up for 6 months. Complete anatomical success was defined as “Total resolution of all the fluid in retinal compartments”. All of the patients had complete resolution of the optic pit maculopathy following surgery. The mean duration for complete resolution was 18.3 weeks. Pattern of resolution of ODP-M was found to be resolution of the subretinal fluid (SRF) followed by disappearance of the retinoschitic lesions (RL) and finally disappearance of macular edema (ME). The proposed minimally invasive procedure (MIP) can produce comparably good and equally reliable results for the treatment of ODP-M.

Congenital optic disc pits and optic disc pit maculopathy: a review.

Optic disc pits are a rare but significant anomaly of the optic nerve head that can lead to visual impairment and associated complications. These pits are characterized by a small, oval-shaped depression in the disc, which can cause fluid accumulation and subsequent damage to the adjacent retina. Although the etiology and pathogenesis of optic disc pits are not fully understood, several theories have been proposed, including abnormal embryonic development and degenerative changes. Diagnosis is typically made through a comprehensive eye examination, including a dilated fundus exam and optical coherence tomography. Management options vary depending on the severity of the condition and associated complications, ranging from observation to surgical intervention.

Evaluation of baseline optic disc pit and optic disc coloboma maculopathy features by spectral domain optical coherence tomography

PurposeThe aim of this study is to describe and compare the baseline demographic, ocular, and imaging characteristics of a cohort of patients with optic disc pit (ODP) or optic disc coloboma (ODC) maculopathy.MethodsThis retrospective study included patients diagnosed with ODP or ODC on clinical examination between June 2017 and December 2022. These patients’ baseline demographics, ocular characteristics, and optical coherence tomography (OCT) imaging characteristics were analyzed.ResultsFundus examination revealed 11 eyes of 11 patients with ODP and 14 eyes of 9 patients with ODC, respectively. On OCT, maculopathy was observed more frequently in ODP (n = 10) than in ODC (n = 4) [p = 0.004] cases. Eyes with ODP were more likely to exhibit retinoschisis and/or serous macular detachment [SMD] (n = 7, 70%), communication of the retinoschisis with the optic disc (p = 0.015), whereas the SMD did not communicate with the optic disc (p = 0.005), and significant outer retinal layer thinning (p = 0.015). In contrast, eyes with ODC exhibited only SMD (p = 0.005) and no retinoschisis on the non-colobomatous retina. SMD in ODC communicated with the margin of the optic disc. In both clinical entities, hyperreflective foci were observed in the SMD.ConclusionIn summary, baseline maculopathy characteristics on OCT, including its type, location, and relationship to the optic disc, are among the most distinguishing characteristics between an ODP and an ODC.Trial Registration NumberNot applicable.

Current advances in the management of optic disc pit maculopathy

ABSTRACT Introduction Although we have been familiar with optic disc pits for a long time, the diagnosis and management of maculopathy remain unclear. Better imaging has improved the diagnosis of this subtle pathology. A recent update on the natural history of optic pit maculopathy marks a paradigm shift in the understanding and management of this condition. There is renewed scope for non-surgical management and less urgency for vitrectomy, which remains the definitive treatment. Areas covered This perspective highlights and critiques the updates on diagnostic imaging, natural history, indications and prognosis for surgery, non-surgical alternatives, and surgical adjuncts. We searched the Medline database using the keywords optic pit AND maculopathy, optic pit AND macular schisis, optic pit AND macular detachment; optic pit AND vitrectomy, optic pit AND laser photocoagulation, and included the salient articles. Expert commentary There has been no major change in the surgical options and outcomes for optic pit maculopathy in recent times, except a greater clarity on the role of vitrectomy without any adjuvants as the primary surgical procedure. The key updates are on better imaging for diagnosis and prognosis, and less urgency for surgery in view of the favorable natural history.

Long-term outcomes of autologous platelet treatment for optic disc pit maculopathy

PurposeOptic disc pits (ODPs) are rare congenital cavitary abnormalities of the optic nerve head, which can lead to serous macular detachments. The aim of this study was to evaluate the long-term efficacy of pars plana vitrectomy (PPV) combined with autologous platelet concentrate (APC) for the treatment of optic disc pit maculopathy (ODP-M).MethodsA retrospective analysis was performed on eleven eyes of ten patients with ODP-M, who received PPV combined with APC. Nine eyes operated primary, four of which had a repeat surgery also with injection of APC and two eyes underwent a rescue surgery, after they have been operated in another eye center without APC. Morphological and functional results were the main outcome parameters, determined by optical coherence tomography (OCT) and best-corrected visual acuity (BCVA), respectively.ResultsThe mean duration of visual loss before surgery was 4.7 ± 3.89 months (range 0–12 months). The mean BCVA increased significantly from 0.82 ± 0.33 logMAR (range 0.4–1.3) preoperatively to 0.51 ± 0.36 logMAR (range 0–1.2) at the last examination (p = 0.0022). A significant morphological improvement was also noticed with decrease of the mean foveal thickness from 935.82 ± 248.48 µm (range 559–1400 µm) preoperatively to 226.45 ± 76.09 µm (range 110–344 µm) at the final examination (p < 0.0001). The patients were followed-up for a mean 65.36 ± 48.81 months (range 1–144 months). Two eyes developed postoperatively a retinal detachment. Cataract surgery was performed in 5 eyes during the follow-up period.ConclusionOur study demonstrated that PPV with APC can improve functional and morphological outcomes, both as a primary and a rescue therapy, without any recurrence over a long follow-up period. To the best of our knowledge, this was the longest observation period regarding the use of APC in treatment of ODP-M.

An incidental finding of a rare anomaly: Intraorbital cyst with coexisting optic disc pit

A 46-year-old gentleman referred for opinion about an orbital mass discovered on imaging for left eye blunt trauma. On examination, an orbital cystic lesion along with an optic nerve pit was found, which has been rarely reported. In this present case, we will describe some investigational findings of such a rarely described anomaly and emphasizing the role of optic nerve imaging in each case of optic disc pit and other malformations of optic nerve.

Macular Retinoschisis from Optic Disc without a Visible Optic Pit or Advanced Glaucomatous Cupping (No Optic Pit Retinoschisis [NOPIR

To review eyes with peripapillary and macular retinoschisis without a visible optic pit or advanced glaucomatous optic atrophy, or No Optic Pit Retinoschisis (NOPIR). Retrospective multicenter case series. The study included 11 eyes of 11 patients. Retrospective study of eyes with macular retinoschisis without a visible optic pit, advanced optic nerve head cupping, or macular leakage on fluorescein angiography. Visual acuity (VA), retinoschisis resolution, months to resolution, and recurrence of retinoschisis RESULTS: The mean age was 68.1 ± 17.6 years, mean intraocular pressure was 17.4 ± 3.8 mmHg, and the mean spherical equivalent refractive error was-3.1 ± 2.9 diopters. No subject had pathologic myopia. Seven subjects were treated for glaucoma, and 9 subjects had nerve fiber layer defects on OCT. All eyes had retinoschisis in the outer nuclear layer (ONL) in the nasal macula and extending to the edge of the optic disc, and 8 subjects had fovea-involving retinoschisis. Three nonfoveal and 4 fovea-involved eyes were observed, and 4 fovea-involved eyes with vision loss underwent surgery. Surgery involved preoperative juxtapapillary laser followed by vitrectomy and membrane and internal limiting membrane peeling with intraocular gas and face-down position. The mean baseline VA was significantly worse in the surgery group than that in the observation group (P= 0.020). Retinoschisis resolved and vision improved in all surgical cases. The mean resolution time for the surgery group was 2.75 ± 0.96 months, which was shorter than that for the observation group (28.0 ± 21.2 months; P= 0.014). No eye developed recurrence of the retinoschisis after surgery. Peripapillary and macular retinoschisis can develop in eyes without a visible optic pit or advanced glaucomatous cupping. Eyes without foveal involvement and those with foveal involvement but only mild decrease in vision can be observed for spontaneous resolution. If there is persistent foveal involvement with vision loss, surgery can improve vision by resolving the macular retinoschisis. Surgery for fovea-involved macular retinoschisis without a visible optic pit resulted in faster anatomic resolution and better vision recovery. Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

Autologous retinal transplant for refractory serous retinal detachment secondary to optic disc pit: a novel surgical approach Retinal transplant and optic disc pit.

To present a new technique to treat refractory retinal detachment secondary to optic disc pit. An interventional case report. A 25-year-old man with congenital optic disc pit had two failed vitrectomies involving laser around the optic disc, internal limiting membrane peel and flap to plug the disc pit, and gas tamponade to reattach the retina. With all options running out, a further vitrectomy with autologous retinal transplant and silicone oil tamponade was carried out to treat the refractory serous retinal detachment; the silicone oil was removed at 6 weeks after the last procedure. The retina remained successfully attached at 6 months post-surgery with the patient maintaining his baseline visual acuity. The use of autologous retinal transplant is a new approach to treat refractory retinal detachment secondary to congenital optic disc anomalies, and adds to our options of dealing with this complex condition when first-line approaches have failed.

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.

Unilateral Double Optic Nerve Head Pits with Serous Macular Detachment

Unilateral Double Optic Nerve Head Pits with Serous Macular Detachment

Glaucomatous optic nerve damage in the contralateral eye of a patient with peripapillary retinoschisis: a case report

BackgroundPeripapillary retinoschisis (PPRS) is often associated with glaucomatous eyes. It usually occurs in eyes with a more advanced stage of glaucoma with obvious optic nerve damage. We report a patient who was found to have PPRS in one eye during a routine physical examination without obvious glaucoma symptoms. Further examination revealed glaucomatous visual field loss and retinal nerve fiber layer defects in the contralateral eye.Case presentationA 55-year-old man presented for a routine physical examination. The anterior segment was normal in both eyes. Fundus examination revealed an elevated and red optic disc in the right eye. In addition, scattered patchy red lesions were seen on the retina on the temporal side of the optic disc. The color and boundary of the left optic disc were normal, and the cup-to-disc ratio was 0.6. Optical coherence tomography showed retinoschisis on the optic nerve head of the right eye throughout the entire circumference, extending to the retina on the temporal side of the optic disc. The intraocular pressure was 18 mmHg OD and 19 mmHg OS. The patient was diagnosed with PPRS (OD). However, no optic disc pit or optic disc coloboma was found. Further examination showed that the visual field of the patient’s right eye was generally normal, while a glaucomatous visual field defect was found in the left eye, which manifested as a nasal step visual field defect. Moreover, stereophotography and a red-free fundus image revealed two retinal nerve fiber layer defects in the supratemporal and infratemporal regions of the retina of the left eye. Continuous intraocular pressure measurement found that the intraocular pressure fluctuated between 18 and 22 mmHg OD and 19–26 mmHg OS during the daytime. Primary open-angle glaucoma was then diagnosed.ConclusionsIn this case, we found that PPRS was associated with glaucomatous optic nerve changes and visual field defects in the fellow eye.