Successful surgical management of optic disc pit maculopathy without internal membrane peeling

Abstract

Optic disc pit is an excavation of the optic nerve head usually seen in association with other abnormalities of the optic nerve, peripapillary retina, or posterior vitreous detachment. In 50% the cases, it might be associated with serous macular detachment. The prevailing theory that explains this disorder is that subretinal fluid which is derived from liquefied vitreous passes through the optic disc pit and elevates the macula. In this study, we report a case of serous macular detachment complicating optic disc pit in a young male patient treated surgically without internal limiting membrane peeling and showed dramatic improvement of vision after 1 year.

Novel Technique for Treatment of Foveoschisis Associated With Optic Disk Pits: Active Aspiration of Intraretinal Fluid

“…Their results were consistent with ours; however, we achieved earlier improvement of CDVA and CMT. 10 Imamura et al and Young et al also performed interventional studies for ODP-M. 8,9 They found that the average duration for CDVA improvement ranged from 2 months to 8 months and that a flat, stable retina could be achieved for 1 year. Their techniques comprised pars plana vitrectomy, various methods for the creation of posterior vitreous face detachment, peeling of the ILM, laser treatment on the temporal edge of the disk, and intravitreal gas injection.…”

“…Diab et al 10 reported the use of vitrectomy and gas injection without ILM peeling to treat a 36-year-old man with optic disk pit-related maculopathy. This showed success at 3 months postoperatively, and they reported improvement of CDVA to 20/100 (from 20/1000 at 2 months preoperatively), as well as reduction in CMT to 474 µ m (from 708 µ m preoperatively).…”

“…9 These include pars plana vitrectomy and induction of posterior vitreous detachment, with or without internal limiting membrane (ILM) removal, as well as laser photocoagulation immediately temporal to the disk and outer retinal layer fenestrations. 10 The rationales for these modes of treatment primarily involve removal of any traction on the retina, thereby forming a pathway for the accumulated fluid to drain into the vitreous cavity and/or block further accumulation of the fluid. 11,12 These treatment methods have achieved varying degrees of success, including eventual absorption of the subretinal and schitic fluid.…”

“…However, achievement of this success may require several weeks (up to 32 weeks). 10 The use of 36-and 39-gauge translocation cannulas, as well as 50-gauge micropipettes with active suction, has been reported in investigations of the removal of the subretinal fluid or retained perfluorocarbon liquid. 13 All of these techniques have involved complications, such as retinal incarceration and/or trauma.…”

Inverted autologous internal limiting membrane for management of optic disc pit with macular detachment

“…Possible side effects of laser photocoagulation near the disc include paracentral scotomas, no change in visual acuity, and a low success rate in the resolution of serous macular detachment. [ 4 ]…”