<p>Optic disc pit maculopathy: tamponade of maculoschisis</p>

Abstract

PurposeTo present rapid and safe closure of the pit-macula communication (PMC) by core vitrectomy and adequate duration gas tamponade as our preferred method of resolving optic disc pit (ODP) maculopathy and to define the term “maculoschisis” in ODP maculopathy as an alternative to the term “schisis-like.”Patient and methodsA twenty-four-year-old female presented with an optical coherence tomography (OCT) confirmed ODP and a “giant” communicating maculoschisis cavity. Central macular thickness (CMT) measured 906 microns, and macular volume was twice normal, at 20.8 mm3. Snellen corrected visual acuity was 20/70. Two months after initial vitrectomy performed elsewhere with short-term gas tamponade (SF6 20%), CMT and visual acuity were not significantly improved. Combined lens extraction/intraocular lens placement and repeat vitrectomy with C3F8 15% gas tamponade were performed, with one supplemental (office) gas injection.ResultsOCT imaging six weeks postoperatively showed definitive closure of the PMC with CMT reduced by 405 microns. Sequestered from its ODP source, foveal schisis fluid then resolved by 12 weeks postoperatively. At final follow-up 3.4 years postoperatively, the macula remained dry with a CMT of 322 microns and a concave foveal contour. Macular volume was reduced to (a normal) 10.2 mm3 and visual acuity had improved to 20/25.ConclusionNo report heretofore has documented rapid, sustained closure of the PMC by gas tamponade as the preferred method of expeditiously resolving ODP maculopathy. However, tamponade PMC closure sequesters ODP fluid and uniquely provides early assurance of ultimate maculopathy resolution. In all other techniques, PMC closure is a trailing phenomenon and success remains uncertain during months to a year or more of (unsequestered) fluid resolution. We suggest that more invasive techniques (laser barrier application to the peripapillary choroid, vitreoretinal interface maneuvers, and pit-plugging) be withheld unless a recurrence is detected during subsequent examinations.

Phantom: A Smoothed Particle Hydrodynamics and Magnetohydrodynamics Code for Astrophysics

“…Caution is required in the use of physical viscosity at high Mach number, since negative stress can lead to the tensile instability (Morris, 1996b;Monaghan, 2000;Gray et al, 2001). For subsonic applications this is usually not a problem since the strain tensor and velocity divergence are small compared to the pressure.…”

Surgical Treatment of Optic Disc Pit Associated with Macular Detachment

“…The rationale of the PPV use is based on the removal of the vitreous traction on the macula which contribute to the development of ODP-M [1,7]. Additionally, the removal of the source of SRF leakage is considered a main aim in treatment of ODP-M [8][9][10]. In our case, PPV and ILM peeling allowed to remove vitreous traction, whereas the inverted ILM flap over the ODP allowed for prevention of fluid leakage to sub-and intraretinal space from vitreous cavity, and it is reported to be an effective method of ODP-M treatment [11].…”