Optic Disc Pit Maculopathy

Steel, David; Suleman, Javid; Murphy, Declan C; Song, Anna; Dodds, Steve Hatfield; Rees, Jon

doi:10.1016/j.ophtha.2018.05.009

Cited by 46 publications

(19 citation statements)

References 40 publications

(44 reference statements)

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“…[ 9 ] Hence, primary surgical management of ODPM is recommended, especially in cases with subretinal fluid (SRF) accumulation. [ 1 ]…”

Section: Discussionmentioning

confidence: 99%

“…The optic disc pit (ODP) is a rare excavated anomaly of the optic nerve head (ONH), with an estimated prevalence of 2/10,000 and no gender or racial predilection. [ 1 ] ODP is most frequently found at the temporal or inferotemporal sections of the ONH, and is assumed as an atypical coloboma of the ONH with dysplastic primitive retinal tissue herniating posteriorly into the subarachnoid space through a defective lamina cribrosa. [ 2 ] Mostly, non-complicated ODP are found to be asymptomatic; however, in 25–75% of cases it may develop maculopathy, characterized by cystoid macular changes and/or serous macular detachment.…”

Section: Introductionmentioning

confidence: 99%

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Inverted ILM Flap Technique in Optic Disc Pit Maculopathy

Tavallali¹,

Sadeghi

Abtahi

et al. 2023

JOVR

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Purpose: To present the outcome of optic disc pit maculopathy (ODPM) managed successfullywith an inverted internal limiting membrane (ILM) flap over the optic disc. A narrative review ofODPM pathogenesis and surgical management techniques are also provided. Case Report: This prospective interventional case series included three eyes of three adultpatients (25–39 years old) with unilateral ODPM and a mean duration of unilaterally decreasedvisual acuity of 7.33 ± 2.40 months (4–12 months). The pars plana vitrectomy with posteriorvitreous detachment induction was performed on eyes, followed by an inverted ILM flap insertionover the optic disc and gas tamponade. Patients were followed for 7–16 weeks postoperatively;best-corrected visual acuity (BCVA) improved dramatically in one patient from 2/200 to 20/25.BCVA in other patients improved two and three lines – to 20/50 and 20/30, respectively. Asignificant anatomical improvement was achieved in all three eyes, and no complication wasdetected throughout the follow-up period. Conclusion: Vitrectomy with inverted ILM flap insertion over the optic disc is safe and can yieldfavorable anatomical improvement in patients with ODPM.

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“…[ 9 ] Hence, primary surgical management of ODPM is recommended, especially in cases with subretinal fluid (SRF) accumulation. [ 1 ]…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Inverted ILM Flap Technique in Optic Disc Pit Maculopathy

Tavallali¹,

Sadeghi

Abtahi

et al. 2023

JOVR

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“… 24 The characteristic presence of SRF at the initial presentation is also a prognostic indicator for progressive disease. 25 Future prospective studies may be planned to objectively assess the configuration of fluid pattern on OCT like SRF or IRF along with assessment of disc pit on automated OCT algorithms. This would help the general ophthalmologist to avoid misdiagnosis and successfully manage maculopathy as it is practised in other macular diseases like diabetic macular edema.…”

Section: Discussionmentioning

confidence: 99%

Treatment outcomes of optic disc pit maculopathy over two decades

Oli

Balakrishnan

2021

Ophthalmol Eye Dis

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Aim: To study the long-term outcomes of optic disc pit maculopathy. Methods: Electronic medical records of 154 patients with optic disc pit were reviewed and 50 patients with optic disc pit maculopathy who met the study criteria were included in the study. Demographic profile of patients, along with clinical characteristics, optical coherence tomography (OCT) features and change in best-corrected visual acuity (BCVA) was recorded. Patients were treated either by observation, barrage laser alone or pars plana vitrectomy (PPV) with optional additional surgical procedures. The primary outcome measures were the change in BCVA and resolution of fluid on OCT. Results: The mean age of patients was 29.96 years (3–62 years) with a follow-up of 27.16 months. The mean baseline BCVA in observation, laser and vitrectomy group was log MAR 0.94, 0.76 and 0.87 and final BCVA was log MAR 0.9, 0.67 and 0.46, respectively. There was a statistically significant improvement in the final BCVA and reduction in subretinal fluid with resolution of the schisis cavity in vitrectomy group than in other groups. On regression analysis significant association was found between final BCVA with baseline BCVA ( R2 = 0.815, p = 0.002), use of C3 F8 endotempanode ( p = 0.004) ILM peeling ( p = 0.012) and use of triamcinolone (TA; p = 0.003). No significant association was found with juxtapapillary endolaser ( p = 0.062). Conclusions: In patients with disc pit maculopathy, PPV lead to better functional and anatomical outcomes as compared to laser or observation alone. Use of surgical adjuvants like ILM peeling, TA and C3F8 tamponade improved the outcomes, unlike juxtapapillary endolaser treatment.

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“…There are several case reports and case series of ODP-M in children in the available literature, but only a few population-based studies have been reported [24]. However, children constitute a unique population that requires a different management style than adults.…”

Section: Diagnostic and Therapeutic Approaches To Optic Disc Pit Maculopathy In Children Introductionmentioning

confidence: 99%

Diagnostic and therapeutic approaches to optic disc pit maculopathy in children

Kalogeropoulos¹,

Asproudis²,

Ch'ng³

et al. 2021

Med Hypothesis Discov Innov Optom

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Background: Optic disc pit (ODP) is a rare congenital defect of the optic disc that can lead to maculopathy and gradual visual impairment. This review summarizes our current knowledge on the diagnostic and therapeutic approaches to ODP maculopathy (ODP-M) in children. Methods: A thorough literature search was performed using the PubMed/MEDLINE database from 1960 to 2020. An additional search was conducted using Google Scholar for completeness. Results: ODP-M is characterized by the accumulation of subretinal and/or intraretinal fluid. The exact pathogenetic mechanisms are not fully understood, and the origin of the fluid remains unknown. Although ODP-M is more likely to occur during the third or fourth decade of life, cases of children with serous retinal detachment have been recorded. Early diagnosis of ODP-M and prompt, appropriate management are crucial, particularly in patients of amblyogenic age. In adults, ODP-M may resolve spontaneously, but most cases require surgical intervention to prevent permanent loss of vision. However, the fact that ODP-M may spontaneously resolve in children cannot be ignored. Various surgical methods have been described, including pars plana vitrectomy (PPV) combined with various techniques, including laser photocoagulation, intravitreal gas injection, and macular buckling. Conclusions: PPV remains the mainstay surgical approach for ODP-M. However, ODP-M may differ between children and adults. Children constitute a unique population of patients that require a different and probably more tailor-made approach. Detailed clinical examination, combined with a thorough analysis of retinal imaging, may improve our understanding of the background and pathophysiology of the disease and eventually provide us with new insights into the management of ODP-M in the pediatric population. How to cite this article: Kalogeropoulos D, Asproudis I, Ch’ng SW, Mitra A, Sharma A, Katsikatsos K, Asproudis C, Kalogeropoulos C. Diagnostic and therapeutic approaches to optic disc pit maculopathy in children. Med Hypothesis Discov Innov Optom.2021 Spring; 2(1): 24-35. DOI: https://doi.org/10.51329/mehdioptometry122

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Optic Disc Pit Maculopathy

Abstract: The incidence and presenting features of ODPM were defined. Patients with SRF had worse vision and were more likely to deteriorate than patients with intraretinal fluid only. Surgery was anatomically successful in 75% of cases. Patients without SRF tended to remain stable with observation.

Cited by 46 publications

References 40 publications

Inverted ILM Flap Technique in Optic Disc Pit Maculopathy

Inverted ILM Flap Technique in Optic Disc Pit Maculopathy

Treatment outcomes of optic disc pit maculopathy over two decades

Diagnostic and therapeutic approaches to optic disc pit maculopathy in children

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