Multicenter study of pars plana vitrectomy for optic disc pit maculopathy: MACPIT study

Abstract

PurposeTo evaluate surgical intervention with pars plana vitrectomy (PPV) for correction of optic disc pit maculopathy (ODP-M).Patients and methodsRetrospective chart review from 13 centres of 51 eyes of 50 patients with ODP-M who underwent PPV between 2002-2014. Anatomic and final best-corrected visual acuity (BCVA) outcomes were evaluated for all cases with different adjuvant techniques.ResultsThere were 23 males and 27 females with median age 25.5 (6-68) years. Preoperative median foveal thickness was 694.5 (331-1384) μm and improved to 252.5 (153-1405) μm. Median BCVA improved from 20/200 (20/20000 to 20/40) to 20/40 (20/2000 to 20/20) with 20/40 or better in 31 eyes. Complete retinal reattachment was achieved in 44 eyes (86.3%) at 7.1 (5.9) months. The good surgical outcomes were achieved in different adjuvant groups. Median follow-up was 24 (6 to 120) months.ConclusionsThese results confirm the long-term effectiveness of PPV for ODP-M. Prospective studies are needed to determine the effectiveness of any adjuvant technique in improving the success of PPV for ODP-M.

Optic disc pit maculopathy and its spectrum of management

“…Pars plana vitrectomy and gas tamponade are considered to be the most effective steps in ODPM surgery. [23] ILM peeling eliminates traction,[45] ensures complete hyaloid removal, and the flap over the pit intercepts the fluid from vitreous cavity (Case 1). But there is risk of macular hole formation[4] in cases where the retina is extremely thinned out.…”

“…In refractory cases (Case 3), if no resolution is noted even after ≥12 months autologous ILM transplantation has been reported to be an effective treatment option. [24]…”

A prospective long‐term follow‐up study of optic disc pit maculopathy treated with pars plana vitrectomy, drainage of subretinal fluid and peeling of internal limiting membrane

“…Disappearance of subretinal fluid was slow in most treated eyes although two eyes already had no subretinal fluid after one month postoperatively. The time for restitution of macular status did, in most cases, not seem to be positively influenced by performing a retinotomy and drainage of subretinal fluid, when compared to what has previously been published (Avci et al 2013;Rayat et al 2015;Avci et al 2017;Bottoni et al 2018). It is noteworthy that two eyes had late recurrences of the serous detachment more than a year after the initial successful PPV surgery.…”

Optic Disc Pit Maculopathy

“…We did not find a significant benefit from ILM peeling, juxtapapillary laser or the use of gas, similar to other recent studies, but the number of cases in our study is too small to be conclusive, with a risk of type II errors. 22,[31][32][33][34][35] Furthermore, 25 different surgeons operated on the included cases without a defined therapeutic protocol, for example for laser application and it is therefore not possible to draw definitive conclusions on the benefit of particular surgical approaches. No surgeon opted to use scleral buckling or gas injection without vitrectomy, reflecting the low adoption of these procedures; this is an observation that others have made previously.…”