Abstract
Background
Optic disc pit (ODP) maculopathy has a poor visual prognosis if left to its natural course. Several therapeutic approaches have been attempted. The cases of 11 patients evaluated with optical coherence tomography (OCT) and treated with vitrectomy–laser–gas and their functional and anatomical outcomes are presented.
Methods
Retrospective interventional consecutive case series, including 11 eyes with ODP maculopathy. Pre- and postoperative best-corrected visual acuity (BCVA), OCT and angiography were recorded. All patients underwent pars plana vitrectomy, posterior hyaloid dissection peripapillary diode laser prior to retinal reapplication and C3F8 15% injection.
Results
Mean preoperative BCVA was 20/126. Median preoperative BCVA was 1.0 LogMAR (range 1.3–0.4) . Eighty-two per cent of patients gained 2 or more Snellen lines of vision (mean 4.4 lines gained). Mean final BCVA was 20/32, and median final BCVA was 20/30 in Snellen VA and 0.2 in LogMAR (range 0.7–0) Preoperative OCT in all but one case confirmed the bilaminar structure of the macular detachment. Postoperative OCT helped in monitoring reabsorption of the macular detachment, which was achieved in all cases after an average of 6.5 months post-surgery. BCVA increased progressively as the subretinal fluid was reabsorbed (P=0.006). Mean duration of postoperative follow-up was 15 months. Recurrence was observed in two cases.
Conclusions
In our series, the vitrectomy–laser–gas procedure for ODP maculopathy improved vision and achieved satisfactory anatomic results in all 11 cases. OCT was useful in the diagnosis and follow-up of this pathology. However, the low incidence of this entity makes it difficult to obtain series large enough to determine the efficacy of the vitrectomy–laser–gas procedure and other treatment modalities and be able to suggest a procedure of choice.
Similar content being viewed by others
References
Bonnet M (1991) Serous macular detachment associated with optic nerve head pits. Graefes Arch Clin Exp Ophthalmol 229:526–532
Brown GC, Brown MM (1995) Repair of retinal detachment associated with congenital excavated defects of the optic disc. Ophthalmic Surg 26:11–15
Cox MS, Witherspoon CD, Morris RE, Flynn HW (1998) Evolving techniques in the treatment of macular detachment caused by optic nerve pits. Ophthalmology 95:889–896
Gandorfer et al (2000) [Role of vitreoretinal interface in the pathogenesis and therapy of macular disease associated with optic pit.] Ophthalmologe 97:276–279
Gass JDM (1967) Serous detachment of the macula secondary to congenital pits of the optic nerve head. Am J Ophthalmol ;67:821–41
Gass JDM (1987) Stereoscopic atlas of macular diseases: diagnosis and treatment, 3rd edn. Mosby, St. Louis, pp 728–733
Hendriske F, Deutman AF (1989) Central serous detachment with optic pit treated by gas injection and laser coagulation. Lasers Light Ophthalmol 2:249–252
Joko T, Kusaka S (1998) Tangential vitreous traction observed in optic disc maculopathy without apparent serous detachment. Ophthalmic Surg Lasers 29:677–679
Konno S, Akiba J, Sato E, Kuriyama S, Yoshida A (2000) OCT in successful surgery of retinal detachment associated with optic nerve pit. Ophthalmic Surg Lasers 31:236–239
Krivoy D, Gentile R, Liebmann JM, et al (1996) Imaging congenital optic disc pits and associated maculopathy using optical coherence tomography. Arch Ophthalmol 114:165–170
Lincoff H, Kreissig I (1998) Optical coherence tomography of pneumatic displacement of optic disc pit maculopathy. Br J Ophthalmol 82: 367–372
Lincoff H, López R, Kreissig I, et al (1988) Retinoschisis associated with optic nerve pits. Arch Opthalmol 106:61–67
Lincoff H, Schiff W, Krivoy D, Ritch R (1996) Optic coherence tomography of optic disk pit maculopathy. Am J Ophthalmol 122:264–266
Mimoun G, Delayre T, Laroche a, Coscas G (1993) Chirurgie des fossettes colobomateuses associées à un décollement séreux maculaire. SFO, Paris
Oshima Y, Emi K (1999) Optical cross-sectional assessment of the macula by retinal thickness analyzer in optic disk pit maculopathy. Am J Ophthalmol 128:106–109
Postel EA,Pulido JS, McNamara JA, Johnson MW (1998) The etiology and treatment of macular detachment associated with optic nerve pits and related anomalies. Trans Am Ophthalmol Soc 96:73–88
Rutledge BK, Puliafito CA, Duker JS, Hee MR, Cox MS (1996)Optical coherence tomography of macular lesions associated with optic nerve head pits. Ophthalmology 103:1047–1053
Schatz H, McDonald HR (1988) Treatment of sensory retinal detachment associated with optic nerve pit or coloboma. Ophthalmology 95:178–186
Snead MP, James N, Jacobs PM (1991) Vitrectomy, argon laser, and gas tamponade for serous retinal detachment associated with an optic disc pit: a case report. Br J Ophthalmol 75:381–382
Sobol WM, Blodi CF, Folk JC, Weingeist TA (1997) Long-term visual outcome in patients with optic nerve pit and serous retinal detachment of the macula. Ophthalmology 11:1539–1542
Taie-Sartal, Mimoun G, Glacet-Bernard A, Delayre T, Coscas G (1996) Vitrectomy-laser-gas for treating optic disk pits complicated by serous macular detachment. J Fr Ophtalmol 19: 603–609
Theodossiadis GP, Theodossiadis PG (2001) Optical coherence tomography in optic disc maculopathy treated by macular buckling procedure. Am J Ophthalmol 132:184–190
Theodossiadis et al (2000) The macular buckling technique in the treatment of optic disc pit maculopathy.Semin Ophthalmol Jun:108–115
Todokoro D, Kishi S (2000) Reattachment of retina and retinoschisis in pit-macular syndrome by surgically-induced vitreous detachment and gas tamponade. Ophthalmic Surg Lasers 31:233–235
Wiethe T (1881) Ein Fall von angeborener Difformität der Sehnervenpapille. Arch Augenheilkd 11:14–19
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
García-Arumí, J., Corcóstegui Guraya, B., Boixadera Espax, A. et al. Optical coherence tomography in optic pit maculopathy managed with vitrectomy–laser–gas. Graefe's Arch Clin Exp Ophthalmol 242, 819–826 (2004). https://doi.org/10.1007/s00417-004-0897-8
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00417-004-0897-8