Surgical approaches to optic disc pit maculopathy: seven case reports

Author: Rosa Pinheiro (Portugal)

Co-authors: Filipe Henriques, Pedro Fonseca, João Figueira, Mário Alfaiate, Joaquim Murta

Purpose

To evaluate the clinical outcomes of 7 patients with optic disc pit maculopathy submitted to different surgical procedures.

Setting/Venue

Noncomparative, retrospective, interventional case series at the University Hospital of Coimbra.

Methods

Seven patients aged 13 to 74 years were submitted to vitreoretinal surgery at the University Hospital of Coimbra throughout 2005 and 2020. Decreased visual acuity (VA) form baseline and macular detachment confirmed with OCT imaging were important criteria for surgical intervention and these were also the main postoperative outcomes. Vitrectomy, posterior hyaloid detachment, and gas tamponade were executed in all cases. Endolaser photocoagulation on the temporal margin of the optic disc, internal limiting membrane (ILM) peeling and stuffing the pit with a free autograft of ILM were selectively performed at the discretion of the surgeon. Follow-up time ranged from 1 to 13 years.

Results

All surgeries consisted in pars plana vitrectomy with posterior hyaloid detachment and gas tamponade with either 14% C3F8 or 20% SF6. Low-fluence argon endolaser was applied to the temporal margin of the optic pit in all but 2 cases; ILM peeling and inverted flap technique were successfully executed in 4 cases and stuffing of the pit with a free autograft of ILM was performed in 2 cases. There was VA improvement in 6 out of the 7 patients, within 4 months to 3 years after surgery. Complete macular reattachment was achieved in 5 cases. Three patients had recurrence of the macular detachment and one was submitted to reoperation. There were no surgical complications besides a cataract.

Conlusions

vitrectomy with posterior vitreous detachment combined with either endolaser photocoagulation, ILM peeling and ILM stuffing techniques were safe and effective procedures for surgical treatment of OPM. Most patients had VA improvement and nearly complete macular reattachment with no recurrence.

Financial Disclosure

No financial interests or relations to declare.