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

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.

Resolution of Optic Disc Pit Maculopathy Following Posterior Vitreous Detachment

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.

Vitrectomy in Serous Macular Detachment Associated with Optic Pit

Optic disc pit is a rare congenital anomaly of the optic disc and may be complicated by maculopathy with progressive vision loss. Optical disc pits are generally unilateral and sporadic, and the pathogenesis of maculopathy is not clear. Optical disc maculopathy (ODP-M) is a condition characterized by intraretinal, subretinal fluid, and retinal layers dissociation (retinoschisis). The origin of the subretinal fluid is controversial, and it is thought to be caused by liquefied vitreous, cerebrospinal fluid (CSF), leakage of the blood vessels in the base of the pit, and choroid. Although there is no consensus on its treatment, pars plana vitrectomy (PPV) alone or combined PPV, juxtapapillary laser photocoagulation, gas tamponade injection are the most frequently used methods in recent years. In this article, literature research was conducted on the possible mechanisms of the optic disc pit and the treatment modalities used.