Comparison of various surgical techniques for optic disc pit maculopathy: vitrectomy with internal limiting membrane (ILM) peeling alone versus inverted ILM flap ‘plug’ versus autologous scleral ‘plug’

2020 ◽  
pp. bjophthalmol-2019-315075 ◽  
Author(s):  
Naresh Babu ◽  
Piyush Kohli ◽  
Kim Ramasamy
Keyword(s):  
Optic Disc ◽  
Surgical Techniques ◽  
Subretinal Fluid ◽  
Internal Limiting Membrane ◽  
Optic Disc Pit ◽  
Ilm Peeling ◽  
Post Surgery ◽  
Optic Disc Pit Maculopathy ◽  
Group 2 ◽  
Anatomical Success

AimTo compare the anatomical and visual outcomes of vitrectomy with internal limiting membrane (ILM) peeling alone versus inverted ILM flap to plug the pit versus autologous scleral plug for the treatment of optic disc pit maculopathy (ODP-M).MethodsThis retrospective study included 23 patients (23 eyes) who underwent 25G pars plana vitrectomy, ILM peeling and gas tamponade. While the pit was not plugged in group 1 (n=8), inverted ILM flap and autologous scleral flap were used to plug the pit in group 2 (n=7) and group 3 (n=8), respectively. Complete anatomical success was defined as total resolution of subretinal fluid (SRF) and macular schisis on optical coherence tomography while visual success was defined as a gain of at least 2 Snellen lines 1 year after surgery.ResultsBaseline characteristics were similar in all three groups. Mean central foveal thickness and SRF decreased in all three groups (p<0.05). Complete anatomical success was achieved in 25.0%, 85.7% and 87.5% eyes while visual success was achieved in 12.5%, 28.6% and 12.5% eyes in groups 1, 2 and 3, respectively. One eye (4.3%) in group 2 developed full-thickness macular hole at 1 month post-surgery. After complete resolution, there was no recurrence of fluid.ConclusionOPD-M has a better surgical outcome if the pit is plugged. Both inverted ILM flap and autologous scleral plug are equally efficacious adjuncts to plug the pit.

scholarly journals A Conservative Surgical Approach to the Treatment of Optic Disc Pit Maculopathy: Four Case Reports

2020 ◽  
Vol 11 (2) ◽  
pp. 196-204
Author(s):  
Emilio Rapizzi ◽  
Paola Gallon ◽  
Diego Ponzin ◽  
Stefano Ferrari ◽  
Nicola Zemella
Keyword(s):  
Optic Disc ◽  
Case Reports ◽  
Posterior Vitreous Detachment ◽  
Subretinal Fluid ◽  
Internal Limiting Membrane ◽  
Conservative Approach ◽  
Optic Disc Pit ◽  
Surgical Interventions ◽  
Optic Disc Pit Maculopathy ◽  
Intravitreal Gas

The purpose of this report is to present the outcomes of surgical interventions in 4 patients with maculopathy associated with optic disc pit (ODP). We report 4 cases of patients affected by ODP maculopathy and treated by core vitrectomy with induction of posterior vitreous detachment and peeling of the internal limiting membrane restricted to the interpapillary macular zone without laser treatment and gas tamponade. The patients had rapid resolution of the multilayer inner retinoschisis-like separation and progressive slow reabsorption of the macular intraretinal and subretinal fluid up to complete retinal reattachment. Currently, there are still no widely accepted guidelines related to the best technique in the management of the maculopathy associated with ODP. We used a conservative approach, without the adoption of intravitreal gas injection or laser.

scholarly journals Inverted ILM flap technique in Optic Disc Pit Maculopathy: An Iranian experience with review of the literature

2021 ◽  
Author(s):  
Ali Tavallali ◽  
Yasaman Sadeghi ◽  
Seyed-Hossein Abtahi ◽  
Hosein Nouri ◽  
Mitra Rezaei ◽  
...  
Keyword(s):  
Optic Disc ◽  
Posterior Vitreous Detachment ◽  
Surgical Techniques ◽  
Case Series ◽  
Internal Limiting Membrane ◽  
Optic Disc Pit ◽  
Review Of The Literature ◽  
Pars Plana ◽  
Optic Disc Pit Maculopathy ◽  
Prospective Case Series

Abstract Purpose To present the outcome of optic disc pit maculopathy (ODPM) managed successfully with inverted internal limiting membrane (ILM) flap over the optic disc. Methods This prospective case series included three patients with ODPM who underwent pars plana vitrectomy with posterior vitreous detachment induction, followed by inverted ILM flap over the optic disc and gas tamponade. Patients were followed for 7-16 weeks as regards their functional and anatomical findings. A narrative review is also provided about Pathology, Pathogenesis, and surgical techniques in the treatment of ODPM Results Three adult patients (25–39 years old) were evaluated, with a mean duration of decreased visual acuity of 7.33 ± 2.40 months (4-12 months). Postoperatively, BCVA improved dramatically in one patient from 2/200 to 20/25. BCVA in the other two improved two and three lines, to 20/50 and 20/30, respectively. Significant anatomic improvement was achieved in all patients. Conclusion Vitrectomy with inverted ILM flap insertion over the optic disc can yield favorable anatomical improvement in patients with ODPM.

scholarly journals Treatment outcomes of optic disc pit maculopathy over two decades

2021 ◽  
Vol 13 ◽  
pp. 251584142110277
Author(s):  
Avadhesh Oli ◽  
Divya Balakrishnan
Keyword(s):  
Optic Disc ◽  
Subretinal Fluid ◽  
Optic Disc Pit ◽  
Long Term Outcomes ◽  
Ilm Peeling ◽  
Pars Plana ◽  
Optic Disc Pit Maculopathy ◽  
The Mean

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.

Optic Disc Pit Maculopathy after Prone Positioning Spine Surgery

2017 ◽  
Vol 27 (5) ◽  
pp. e144-e146
Author(s):  
Marcos Ruiz-Sánchez ◽  
Maria E. Rodríguez-González-Herrero ◽  
Jenifer Ruiz-Sará
Keyword(s):  
Optic Disc ◽  
Prone Position ◽  
Spine Surgery ◽  
Patient Positioning ◽  
Internal Limiting Membrane ◽  
Prone Positioning ◽  
Optic Disc Pit ◽  
Visual Acuity Loss ◽  
Optic Disc Pit Maculopathy

Purpose To report a case of optic disc pit maculopathy after spine surgery performed in the prone position. Methods Case report. Results A 32-year-old man underwent spine surgery for disc herniation repair. He complained of visual acuity loss immediately after the procedure. Optic disc maculopathy with internal limiting membrane detachment was found to be the cause. Vitrectomy was scheduled after a 12-month follow-up without resolution of the maculopathy. Conclusions Optic disc maculopathy has not previously been associated with nonocular surgery or patient positioning. Physiologic changes induced by the prone position likely altered the pressure gradient in the eye and led to the development of the maculopathy.

scholarly journals Refined Internal Limiting Membrane Inverted Flap Technique for Intractable Macular Detachment with Optic Disc Pit

2017 ◽  
Vol 8 (1) ◽  
pp. 208-213 ◽  
Author(s):  
Rumiko Hara ◽  
Yasutomo Tsukahara ◽  
Tsuyoshi Simoyama ◽  
Soutarou Mori
Keyword(s):  
Optic Disc ◽  
Subretinal Fluid ◽  
Internal Limiting Membrane ◽  
Vitreous Cavity ◽  
Subretinal Space ◽  
Optic Disc Pit ◽  
Case Presentation ◽  
Macular Detachment ◽  
Space Case ◽  
The Right

Purpose: To report a surgical technique for retinal detachment associated with optic disc pit (ODP) by using an internal limiting membrane (ILM) inverted flap as an obstacle between the vitreous cavity and subretinal space. Case Presentation: A 43-year-old man presented with decreased visual acuity in the right eye for 1 week due to macular detachment associated with ODP. After 2 unsuccessful surgeries, the retina was reattached by vitrectomy with an ILM inverted flap onto the ODP. Conclusion: Covering the pit with an inverted ILM flap is a reliable method for intercepting fluid from the vitreous cavity. Immediate absorption of subretinal fluid may lead to early macular attachment. This technique would be effective in managing ODP.

Fibrin Glue and Internal Limiting Membrane Abrasion for Optic Disc Pit Maculopathy

2018 ◽  
Vol 49 (12) ◽  
pp. e271-e277 ◽  
Author(s):  
David R. P. Almeida ◽  
Eric K. Chin ◽  
Parnian Arjmand ◽  
Gabriel Velez ◽  
Lucy P. Evans ◽  
...  
Keyword(s):  
Optic Disc ◽  
Fibrin Glue ◽  
Internal Limiting Membrane ◽  
Optic Disc Pit ◽  
Optic Disc Pit Maculopathy

Incidence and Evolution of Subretinal Precipitates in Optic Disc Pit Maculopathy

2017 ◽  
Vol 27 (6) ◽  
pp. 769-773
Author(s):  
Irini Chatziralli ◽  
George Theodossiadis ◽  
Dimitrios Brouzas ◽  
Panagiotis Theodossiadis
Keyword(s):  
Optic Disc ◽  
Successful Treatment ◽  
Outer Part ◽  
Subretinal Fluid ◽  
Fundus Photography ◽  
Optic Disc Pit ◽  
Fluid Accumulation ◽  
Photoreceptor Layer ◽  
Optic Disc Pit Maculopathy ◽  
Baseline Examination

Purpose To study the evolution of subretinal precipitates coexistent with optic disc pit (ODP) maculopathy from their appearance at baseline examination until their absorption after successful treatment. Methods Participants in this retrospective, multicenter study were 42 patients with ODP maculopathy, in whom complete ocular examination was performed, including visual acuity (VA) measurement, slit-lamp examination, color or red-free fundus photography, and optical coherence tomography at baseline after surgical treatment. Results Out of 42 cases, 17 (40.5%) cases of ODP maculopathy, which were examined between 2002 and 2015, were found to have subretinal precipitates associated with multilayer fluid accumulation at baseline. Precipitates were located at the outer part of the photoreceptor layer and remained for 3-6 months after successful treatment and absorption of subretinal fluid. The mean VA was 0.99 ± 0.21 logMAR at baseline and improved to 0.54 ± 0.25 logMAR at the final examination. Conclusions Macular precipitates in association with signs of disease chronicity, such as multilayer fluid accumulation, became evident at baseline examination. Precipitates’ disappearance in 15 out of 17 cases coincided with the absorption of subretinal fluid. The relative low VA at baseline probably could be attributed to the chronicity of the disease.

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