Incidence and Evolution of Subretinal Precipitates in Optic Disc Pit Maculopathy

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.

Download Full-text

Resolution of Optic Disc Pit Maculopathy Following Posterior Vitreous Detachment

Journal of VitreoRetinal Diseases ◽

10.1177/24741264211046766 ◽

2021 ◽

pp. 247412642110467

Author(s):

Ali H. Mannaa ◽

Reda A. Issa ◽

J. Shepard Bryan

Keyword(s):

Optic Disc ◽

Posterior Vitreous Detachment ◽

Interesting Case ◽

Optic Disc Pit ◽

Review Of The Literature ◽

Fluid Accumulation ◽

Optic Pit ◽

Vitreous Detachment ◽

Spontaneous Improvement ◽

Optic Disc Pit Maculopathy

Purpose: This work presents a case of significant improvement of optic pit disc maculopathy following an acute posterior vitreous detachment (PVD) and discusses the possible mechanisms of this phenomenon. Methods: A case report and review of the literature are presented. Results: A 56-year-old man presenting with progressive visual decline in his left eye was found to have an optic disc pit with optical coherence tomography (OCT) evidence of severe intraretinal edema and maculoschisis. His visual acuity and macular anatomy on OCT improved dramatically in the months following a PVD. Conclusions: This report presents an interesting case of spontaneous improvement of optic disc pit–related maculopathy following PVD. We discuss the cause of the retinal fluid accumulation in optic disc pit maculopathy and consider that the OCT findings in our case lend credence to the theory that this fluid originates from the vitreous humor.

Download Full-text

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.

Download Full-text

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.

Download Full-text

Restoration of the photoreceptor layer and improvement of visual acuity in successfully treated optic disc pit maculopathy: a long follow-up study by optical coherence tomography

Graefe s Archive for Clinical and Experimental Ophthalmology ◽

10.1007/s00417-011-1918-z ◽

2012 ◽

Vol 250 (7) ◽

pp. 971-979 ◽

Cited By ~ 15

Author(s):

George P. Theodossiadis ◽

Vlassis G. Grigoropoulos ◽

Vasilis S. Liarakos ◽

Alexandros Rouvas ◽

Ioannis Emfietzoglou ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Visual Acuity ◽

Optic Disc ◽

Optical Coherence ◽

Optic Disc Pit ◽

Photoreceptor Layer ◽

Follow Up Study ◽

Optic Disc Pit Maculopathy

Download Full-text

Treatment outcomes of optic disc pit maculopathy over two decades

Therapeutic Advances in Ophthalmology ◽

10.1177/25158414211027715 ◽

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.

Download Full-text