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

Abstract

Purpose To evaluate the results of surgical treatment of maculopathy secondary to congenital optic pit anomaly with pars plana vitrectomy (PPV), endolaser to the temporal edge of the optic disc and C3F8 tamponade without internal limiting membrane (ILM) peeling. Patients and methods Thirteen eyes of 12 patients with serous macular detachment and/or macular retinoschisis secondary to congenital optic disc pit (ODP) were included in the study. All eyes underwent PPV, posterior hyaloid removal, endolaser photocoagulation on the temporal margin of the optic disc and 12% C3F8 gas tamponade. Anatomic success and functional outcome determined retrospectively by optical coherence tomography and measurement of best corrected visual acuity (BCVA), respectively were the main outcome parameters. Results Two lines or more improvement in BCVA was obtained in 11 eyes and 6 of these eyes had 20/40 or better BCVA at the final visit. Subretinal or intraretinal fluid was completely resorbed postoperatively in 12 eyes but a little intraretinal fluid persisted in one eye at the 16-month follow-up. Better visual improvement was observed in patients treated by earlier surgical intervention. Conclusion PPV, C3F8 gas tamponade and endolaser to the optic disc margin without ILM peeling may yield favourable results in the treatment of ODP maculopathy.

Efficacy of Internal Limiting Membrane Flap Techniques with Vitrectomy for Macular Detachment Associated with an Optic Disc Pit

“…Also, of the patients with attached macula, 80% required more than 180 days for reattachment to occur. This is in keeping with previous studies that showed that improvement of vision is related to restoration of the normal retinal morphology [10-14, 19, 21, 22, 25-31]. This becomes progressively more evident 6–12 months postoperatively, as submacular fluid is slow to resolve (Table 3).…”

“…However, this method of treatment has largely fallen out of favour because the location of laser treatment over the maculopapular bundle can cause significant visual field defects [10, 11, 13]. Our results suggest that laser treatment does not aid in anatomical success.…”

“…Even though several successful treatments have been reported (Table 3), there are still no established guidelines for the optimal surgical technique or for the treatment of ODP associated with maculopathy [8, 10, 11, 13]. Similarly, there is little consensus regarding which combination of adjuvant procedures to PPV maximizes surgical success while minimizing side effects and possible complications [10-22]. This is partly due to the lack of understanding of the pathophysiology of macular detachment and the possible sources of the fluid.…”

“…Currently, the most widely accepted treatment for this condition is pars plana vitrectomy (PPV). The necessity of adjuvant surgical procedures such as temporal ODP endolaser photocoagulation [10-13], autologous platelet concentrate [14] and many others remains unclear. Nevertheless, interventions for the treatment of ODP maculopathy are valuable, as they may prevent significant visual loss in these patients.…”

Levels of beta‐trace protein in optic disc pit with macular detachment

“…2012; Avci et al. 2013), as does the reported spontaneous healing of macular detachment after posterior vitreous detachment (Bonnet 1991). …”