Function and morphology in macular retinoschisis associated with optic disc pit in a child before and after its spontaneous resolution

Abstract

Optic disc pit (ODP) is a rare congenital defect within the optic nerve head. Macula elevation associated with ODP develops in 75-93% of the adult patients. Macular involvement in children with optic disc pit is rare, and only a few cases have been published to date. In the present case, we have observed morphology and function of the central retina in a child with ODP-associated macular detachment and following its spontaneous resolution. An 8-year-old white boy diagnosed with a macular detachment in an eye with an ODP. Optical coherent tomography (OCT) and multifocal electroretinography (mfERG), as well as visual acuity and visual field, were performed in the follow-up of the unilateral schisis-like retinal detachment. A large retinoschisis associated with ODP in a child showed a tendency to spontaneously resolve at 3 months, which was confirmed on OCT. At this time, an mfERG revealed markedly reduced responses. Despite morphologic reattachment at follow-up and improvement in visual acuity, increased mfERG responses were still not the same as in the fellow healthy eye. In contrast to the OCT which is very helpful to assess the extent of the neurosensory detachment, the mfERG offers an additional tool for follow-up of retinal function in this disorder. The good visual outcome in our patient shows that in the presence of residual retinal function on mfERG and in the absence of further lesions on OCT, follow-up is a valid option in children with an ODP-associated macular detachment.

Long-term outcomes of pars plana vitrectomy without internal limiting membrane peeling for optic disc pit maculopathy

“…This situation is observed not only due to serous macular detachment but also due to separation within the inner layers of the retina. [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] Treatment of ODP associated maculopathy is somewhat controversial because there is no consensus regarding the indications for surgical intervention, or the methods and techniques of surgery. Although there are several treatment options for this pathology, none of them has been generally accepted as a choice of treatment method that is shown to be superior to the other treatment methods.…”

Spontaneous Resolution of Optic Disk Pit Maculopathy in a Child After a Six-Year Follow-Up

“…Five cases of spontaneous resolution of ODP-M in children are present in literature, and OCT was performed in only 2 of them. 3,7 Our case showed a spontaneous resolution that was well documented with SD-OCT and functional examination that included microperimetry. This is the longest OCT follow-up present in the literature.…”

“…2 Few cases of ODP-M in children have been reported, and spontaneous resolution has been described in only five cases. [3][4][5][6][7] Here, we describe a case of spontaneous resolution of ODP-M in a child with a 6-year follow-up.…”

Acetazolamide assisted rapid resolution of optic disc pit maculopathy in a 15 year old child

“…The source of submacular fluid in OPD-M is controversial and has been suggested to arise from cerebrospinal fluid or liquefied vitreous entering the submacular space through a communication either between the subarachnoid space and the optic pit or through a fenestration in the membrane overlying the pit. There are a few cases reported in literature of spontaneous resolution of maculopathy due to optic disc pit in children 6,7 and adults, 1,8-10 25% of ODP-Ms do resolve spontaneously, but mostly these result in poor visual outcome, especially if subretinal fluid persists for more than 3 months. 2 As the disease mechanism is still not understood, the management strategy remains debatable.…”