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
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To investigate by optical coherence tomography (OCT) the evolution of the photoreceptor layer and its association with best-corrected visual acuity (BCVA) in optic disc pit (ODP) maculopathy after successful surgical treatment.
Fourteen eyes of 14 patients were included in this study, and followed up from 36 to 95 months (mean 57.36 ± 18.32 months). The follow-up period started at the time of complete subretinal fluid absorption. Examination was performed by time-domain OCT before and after treatment. Spectral-domain OCT was used after treatment. Parameters assessed were type of elevation, central foveal thickness, time elapsed from onset to treatment, type of treatment, BCVA, and inner segment outer segment (IS/OS) junction line. The IS/OS junction was characterized after treatment as intact, interrupted, or absent (not distinguishable).
Significant restoration of the IS/OS junction line was first noticed between 6 and 12 months after fluid absorption (p = 0.02; Wilcoxon signed rank test). Restoration was continuous up to the 24th month of postoperative examination after fluid absorption (p = 0.14; Wilcoxon signed rank test). BCVA was 0.99 ± 0.38 logMar before treatment, 0.81 ± 0.26 logMar (p = 0.011; paired t-test) immediately after fluid absorption and 0.61 ± 0.33 logMar (p = 0.026; one-way ANOVA) 24 months after fluid resolution. BCVA was significantly positively correlated with the integrity of the IS/OS junction line during follow-up (Pearson r = 0.775; p < 0.001).
The IS/OS junction restoration cannot be detected immediately after fluid resolution in the majority of cases. It became evident 6–12 months later and was completed 24 months after fluid absorption. Improvement in BCVA was noticed only during the first 2 years of follow-up. No significant changes were noticed in BCVA or the IS/OS line after 2 years. Among the studied variables, the final photoreceptor layer condition and BCVA immediately after fluid absorption are the main factors predicting final BCVA after successful surgical treatment of ODP maculopathy.
KeywordsOptic disc pit maculopathy Inner outer segment junction line (IS/OS) Best-corrected visual acuity Optical coherence tomography
The above authors confirm that the manuscript with the above title submitted for consideration for publication in Graefe’s Archive for Clinical and Experimental Ophthalmology is not related with any proprietary or commercial interests. No sponsoring organizations have been involved, and no grants were received from any organization or institution.
- 1.Wiethe T (1882) Ein Fall von angelborener Difformität der Sehnervenpapille. Arch Augenheiikd 11:14–19Google Scholar
- 13.Theodossiadis GP, Panopoulos M, Kollia AK, Georgopoulos G (1992) Long-term study of patients with congenital pit of the optic nerve and persistent macular detachment. Acta Ophthalmol 70:495–505Google Scholar
- 36.Theodossiadis PG, Grigoropoulos VG, Theodossiadis GP (2011) The significance of the external limiting membrane in the recovery of photoreceptor layer after successful macular hole closure: a study by spectral domain optical coherence tomography. Ophthalmologica 225:176–184PubMedCrossRefGoogle Scholar
- 40.Theodossiadis PG, Theodossiadis GP, Charonis A, Emfietzoglou I, Grigoropoulos VG, Liarakos VS (2011) The photoreceptor layer as a prognostic factor for visual acuity in the secondary epiretinal membrane after retinal detachment surgery: imaging analysis by spectral-domain optical coherence tomography. Am J Ophthalmol 151:973–980Google Scholar