Natural Course of Optic Disc Pit Maculopathy: An Optical Coherence Tomography Study

Abstract

Purpose: To analyze the impact of OCT characteristics on the natural course of Optic-Disc-Pit-Maculopathy (ODP-M). Methods: Single-center, retrospective, observational case series. Patients with ODP-M were included in the study. Baseline demographic characteristics, central macular thickness (CMT), intrapapillary proliferation (IPP), subretinal fluid (SRF), subretinal precipitations, outer retinal fluid (ORF) and outer retinal layer hole (ORH) were evaluated. The changes of the OCT characteristics were analyzed with respect to the best-corrected visual acuity (BCVA) from baseline to the last visit. Results: Twenty-two eyes of 22 patients were evaluated with a mean follow-up time of 37.6 (median 22) months. The mean BCVA was 0.31 logMAR at baseline and 0.28 logMAR at the final visit (p=0.521). Baseline BCVA was significantly related to CMT (β coefficient 0.001, p=0,002). Mean BCVA increased in seven patients (Group-1), remained stable in nine (Group-2), and decreased (Group-3) in six patients. No significant difference was found between the groups regarding the baseline BCVA, CMT and extent of retinal fluid. In patients with subretinal deposits, BCVA remained stable in three patients and worsened in one. ORF was recorded in all patients. In patients with SRF, the mean change of BCVA during follow-up differed significantly depending on the presence (0.07 logMAR) or absence (-0,125 logMAR) of SRF (p=0.019). Conclusion: Among the OCT characteristics, SRF was a negative prognostic factor in ODP-M. Most ODP-M patients showed improved or stable vision over three years of follow-up. Therefore, observation may be considered in patients with reasonable vision and without SRF, even when they present with remarkable OCT findings.

Congenital Optic Disc Anomalies: Insights from Multimodal Imaging

“…It usually presents as a unilateral greyish oval or round depression, which tends to be located in the temporal segment of the optic disc and can sometimes be associated with ODC [ 19 ]; it is bilateral in 15% of patients. It is commonly congenital but can also be acquired and associated with glaucoma and myopia [ 20 ]. Like ODC, congenital ODP can also be related to various systemic diseases (Aicardi, Alagille syndrome, neurological developmental malformations) and to specific gene mutations (such as PAX2).…”

“…He also reported intraretinal fluid in about 78% of patients [ 26 ]. Subretinal fluid (SRF) is described as less common than other fluid distribution but correlates with a decrease in vision and deterioration in functional prognosis, especially when associated with subretinal hyperreflective deposits, which are an indicator of chronicity of ODP-M [ 20 , 27 ]. Lamellar macular holes have been reported in association with ODP-M [ 26 ].…”