Clinical manifestations of optic pit maculopathy as demonstrated by spectral domain optical coherence tomography

Abstract

PurposeThe purpose of this retrospective study was to evaluate the characteristic features, including spectral-domain optical coherence tomography (SD-OCT), clinical course, and outcome of treatment if given for patients with optic disc pit maculopathy.MethodsWe investigated a consecutive series of patients with a diagnosis of optic pit maculopathy treated between 2001 and 2012 at the Bascom Palmer Eye Institute. Patients were divided into two main groups, ie, patients who were observed without surgery and patients who received surgical intervention. The main outcome measures were presenting and final visual acuity, and changes in SD-OCT imaging were recorded. Other data including age, gender, eye, age of onset, length of follow-up, location of optic pit, and location of fluid by OCT were also recorded.ResultsOn OCT, 67% (12/18) of the eyes showed schisis-like cavities, 22% (4/18) had only subretinal fluid, and 17% (3/18) had only a schisis-like cavity without subretinal fluid. In the patients managed by observation, visual acuity was ≥20/200 in 6/8 eyes initially and 6/8 eyes at last follow-up. Ten of 18 patients received either focal laser, surgery or both. Six of 10 eyes undergoing surgery had initial visual acuity ≥ 20/200, and 8 of 10 eyes undergoing surgery had a visual acuity of ≥20/200 at last follow-up.ConclusionIn this study, many eyes were observed and remained stable during follow-up. In eyes with reduced vision, surgical intervention produced variable outcomes, and persistent intraretinal/subretinal fluid was a common occurrence.

Serous Macular Detachment Secondary to Optic Pit: Surgical Treatment and Long Time Results

“…Twenty-five percent of cases with maculopathy secondary to optic pit resolve spontaneously [ 7 ]. However, the poor visual outcome of conservative management has prompted use of a more aggressive approach [ 8 ].…”

Spectral domain optical coherence tomography imaging in optic disk pit associated with outer retinal dehiscence

“…Twenty-five percent of ODP-M cases resolve spontaneously, 2 but the poor visual outcome of conservative management 21 has prompted use of a more aggressive approach. The treatment options range from barrage laser photocoagulation to vitrectomy, with or without adjunctive procedures such as internal limiting membrane (ILM) peel and gas tamponade.…”

“…FTMH as a postoperative complication following surgery for ODP-M was similarly reported in other studies. 13 , 21 In the absence of strong evidence for any particular treatment, it may be prudent to adopt a graded approach, starting with argon laser photocoagulation and progressing to surgery if the maculopathy fails to resolve. It is also unknown if morphological features, such as multilayered schisis, outer retinal dehiscence, or neurosensory detachment, may necessitate earlier or more aggressive treatment for better visual outcome.…”

Anwendungsgebiete für die Optische Kohärenztomografie (OCT) in der Neuroophthalmologie

“…Sehr häufig sind schisisartige Veränderungen im OCT zu sehen. Charakteristisch ist, dass die Flüssigkeit und meist auch die Schisis bis an die Papille heranreicht [33] (l " Abb. 6).…”