Optic Disc Pit Maculopathy after Prone Positioning Spine Surgery

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.

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

European Journal of Ophthalmology ◽

10.1177/11206721211023727 ◽

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.

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

Case Reports in Ophthalmology ◽

10.1159/000507880 ◽

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.

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Optical Coherence Tomography Before and After Vitrectomy with Internal Limiting Membrane Removal in a Child with Optic Disc Pit Maculopathy

Japanese Journal of Ophthalmology ◽

10.1007/s10384-004-0225-1 ◽

2005 ◽

Vol 49 (5) ◽

pp. 411-413 ◽

Cited By ~ 28

Author(s):

Kohei Ishikawa ◽

Hiroko Terasaki ◽

Masako Mori ◽

Kimiko Sugita ◽

Yozo Miyake

Keyword(s):

Optical Coherence Tomography ◽

Optic Disc ◽

Internal Limiting Membrane ◽

Optical Coherence ◽

Optic Disc Pit ◽

Before And After ◽

Optic Disc Pit Maculopathy

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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’

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2019-315075 ◽

2020 ◽

pp. bjophthalmol-2019-315075 ◽

Cited By ~ 2

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.

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A prospective long‐term follow‐up study of optic disc pit maculopathy treated with pars plana vitrectomy, drainage of subretinal fluid and peeling of internal limiting membrane

Acta Ophthalmologica ◽

10.1111/aos.14475 ◽

2020 ◽

Vol 98 (8) ◽

pp. 822-827

Author(s):

Karim Makdoumi ◽

Sven Crafoord

Keyword(s):

Pars Plana Vitrectomy ◽

Subretinal Fluid ◽

Internal Limiting Membrane ◽

Optic Disc Pit ◽

Follow Up Study ◽

Long Term Follow Up ◽

Pars Plana ◽

Optic Disc Pit Maculopathy

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

10.21203/rs.3.rs-1125052/v1 ◽

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.

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