scholarly journals Management of Recurrent Optic Disc Pit-Associated Maculopathy with Human Amniotic Membrane Graft in a Pediatric Case: A Case Report

2021 ◽  
pp. 734-739
Author(s):  
Aditya Kelkar ◽  
Jai Aditya Kelkar ◽  
Mounika Bolisetty ◽  
Ashwani Kanoriya
Keyword(s):  
Optic Disc ◽  
Amniotic Membrane ◽  
Subretinal Fluid ◽  
Internal Limiting Membrane ◽  
Human Amniotic Membrane ◽  
Optic Disc Pit ◽  
Primary Surgery ◽  
Ocular Coherence Tomography ◽  
Pars Plana

A 13 years old previously operated with 25-G pars plana vitrectomy with double internal limiting membrane peel and juxtapapillary endolaser with SF 6 gas tamponade for optic disc pit-associated maculopathy (ODP-M), presented with recurrence after 9 months of successful primary surgery. Three 25-G sclerotomies were made and Human Amniotic Membrane Graft was tucked into the optic disc pit (ODP), the position of the graft was confirmed with intraoperative ocular coherence tomography. Subretinal fluid rapidly resolved within 48 h and best-corrected visual acuity improved to 0.5 LogMAR after 1 week. During the follow-up period of 12 months, no episodes of recurrence or reduction vision or adverse reactions were noted.

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.

Management of optic disc pit-associated maculopathy: A case series from a tertiary referral center

2021 ◽  
pp. 112067212110237
Author(s):  
Ilkay Kilic Muftuoglu ◽  
Ecem Onder Tokuc ◽  
V Levent Karabas
Keyword(s):  
Optic Disc ◽  
Case Series ◽  
Internal Limiting Membrane ◽  
Maximum Height ◽  
Optic Disc Pit ◽  
Tertiary Referral Center ◽  
Number Of Patients ◽  
The Mean ◽  
Foveal Center

Purpose: To report outcomes of pars plana vitrectomy (PPV) combined with internal limiting membrane (ILM) stuffing technique in patients with optic disc pit associated maculopathy (ODP-M). Methods: Data including best-corrected visual acuity (BCVA), central macular thickness (CMT), foveal center point thickness (FCP), and maximum height of fluid (max_fluid) (intraretinal or subretinal) were collected from the medical records of the patients. Results: Six eyes of six patients with a mean age of 28.0 ± 17.68 years (range: 9–53 year) underwent PPV + ILM plug surgery. The mean follow-up duration was 25.62 ± 26.11 months (range: 11.80–78.00 month) duration. The mean BCVA increased from 1.25 ± 1.04 logMAR (20/355, Snellen equivalent) to 0.86 ± 1.09 logMAR (20/144, Snellen equivalent) at last follow-up ( p = 0.043). Compared to baseline, CMT, FCP, and max_fluid significantly decreased at all visits after the surgery ( p < 0.05 for all visits). At last follow-up, 66.6% of the eyes (four eyes) showed complete resolution of fluid at a mean of 5.25 ± 4.99 months (range: 1–12 months) after the surgery. Conclusion: PPV with ILM plug seemed to be an effective surgical technique in ODP-M. Studies with longer follow-up and higher number of patients are needed to confirm our results.

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.

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.

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 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.

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 Human amniotic membrane for the treatment of large and refractory macular holes: a retrospective, multicentric, interventional study

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Magno A. Ferreira ◽  
André Maia ◽  
André J. Machado ◽  
Raquel E. A. Ferreira ◽  
Luiz Felipe Hagemann ◽  
...  
Keyword(s):  
Amniotic Membrane ◽  
Retrospective Chart Review ◽  
Functional Results ◽  
Internal Limiting Membrane ◽  
Human Amniotic Membrane ◽  
Off Label ◽  
Macular Holes ◽  
Wilcoxon Rank Sum Test ◽  
Snellen Chart

Abstract Background The purpose of the current study is to report the anatomical and functional results of off-label human amniotic membrane graft as primary intervention to repair large to giant macular holes and in reoperations when wide internal limiting membrane peeling was unsuccessful. Methods Retrospective chart review was carried out in five different centers to identify all cases that had undergone off-label human amniotic membrane graft for the treatment of large or failed macular holes (MH). Data collected included age, gender, other concomitant diagnosis, symptoms duration, lens status, number of previous surgeries, macular hole measurements (minimum and base linear diameters), mean post-operative follow-up (months), and pre- and post-operative best corrected visual acuity (BCVA). Main outcome measures were anatomical MH closure rates and final BCVA (in logMAR). Nonparametric Wilcoxon rank-sum test was used because the data was not normally distributed, a P values < 0.05 were considered statistically significant. Results Nineteen eyes of 19 patients were identified and included in the study. Mean age was 66.21 ± 14.96 years and predominantly females (84%). All eyes had successfully closed MH with a single intervention with no recurrences during a mean of 9 ± 3.87 months follow-up. The median BCVA in logMAR preoperative was 1.30 ± 0.44 (0.80–2.0), approximately 20/400 on Snellen chart and the median BCVA in logMAR postoperative was 1.0 ± 0.72 (0.4–3.0) approximately 20/200 (p < 0.0001) with median of three lines of visual improvement. Conclusion The use of human amniotic membrane graft seems to be a viable and effective alternative for the treatment of large and persistent macular holes. However, further larger prospective controlled studies are necessary to confirm our preliminary results of this new surgical technique.

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