|Year : 2019 | Volume
| Issue : 8 | Page : 1336-1337
Optic disc pit maculopathy and its spectrum of management
Rebika Dhiman, Srikant K Padhy, Toshit Varshney, SJ Vikas, Prashant Kumar, Atul Kumar
Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
|Date of Submission||21-Nov-2018|
|Date of Acceptance||14-Mar-2019|
|Date of Web Publication||22-Jul-2019|
Prof. Atul Kumar
Department of Ophthalmology, Retina, Uvea and ROP Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Ansari Nagar, New Delhi - 110 029
Source of Support: None, Conflict of Interest: None
Keywords: Autologous ILM transplant, ILM peeling, OCT, Optic disc pit, optic disc pit maculopathy
|How to cite this article:|
Dhiman R, Padhy SK, Varshney T, Vikas S J, Kumar P, Kumar A. Optic disc pit maculopathy and its spectrum of management. Indian J Ophthalmol 2019;67:1336-7
|How to cite this URL:|
Dhiman R, Padhy SK, Varshney T, Vikas S J, Kumar P, Kumar A. Optic disc pit maculopathy and its spectrum of management. Indian J Ophthalmol [serial online] 2019 [cited 2019 Dec 14];67:1336-7. Available from: http://www.ijo.in/text.asp?2019/67/8/1336/263124
Optic disc pit maculopathy (ODPM) encompasses serous macular detachment and retinoschisis. There are no discrete recommendations as to the best management option. Here, we describe three cases of ODPM managed differently in various situations.
Our first case was a 15-year-old girl was diagnosed with ODPM with best-corrected visual acuity (BCVA) of counting finger at 1 m in left eye [Figure 1]a, [Figure 1]b, [Figure 1]c. A 23-gauge pars plana vitrectomy (PPV), brilliant blue dye (BBG) assisted ILM peeling and tucking of the free ILM flap into the ODP was done [Figure 1]d.
|Figure 1: Case 1 (a) SSOCT left eye showing retinoschisis involving multiple retinal layers; and (b) neurosensory detachment extensing up to the temporal edge of the pit; (c) Colour fundus photograph of left eye showing optic disc pit and associated serous retinal detachment; (d) PPV with ILM peeling and flap being tucked in the pit|
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The second case was a 34-year-old woman with BCVA of 20/200 in the affected right eye [Figure 2]a. SSOCT exhibited associated foveal thinning [Figure 2]b. So, fovea-sparing ILM flap was fashioned such that 2/3rd disc diameter of ILM was left attached over the fovea [Figure 2]c.
|Figure 2: Case 2 (a) SSOCT image of the right eye showing retinoschisis with neurosensory detachment at the macula and severe foveal thinning; (b) Color fundus photograph of left eye showing optic disc pit and associated macular retinal detachment; (c) Modified technique of foveal-sparing ILM peel being done to avoid the risk of macular hole; ILM flap created was tucked in the pit|
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Our third case was 21-year-old women with previously failed surgery (PPV with conventional ILM flap) for ODMP right eye [Figure 3]b. ILM flap was not visible on SSOCT over the ODP [Figure 3]a. Autologous ILM transplantation and gas tamponade was performed using the ILM harvested from the nasal retinal [Figure 3]c.
|Figure 3: Case 3 (a) SSOCT image of the right eye showing retinoschisis with persistent neurosensory detachment at the macula; (b) Color fundus photograph of right eye showing optic disc pit maculopathy that failed to resolve after first surgery; (c) ILM transplantation being done over the pit using the ILM harvested from the nasal retina|
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All cases reported complete resolution of fluid with a BCVA >20/80 in all cases during the mean follow-up of 9 months.
| Discussion|| |
Pars plana vitrectomy and gas tamponade are considered to be the most effective steps in ODPM surgery., ILM peeling eliminates traction,, ensures complete hyaloid removal, and the flap over the pit intercepts the fluid from vitreous cavity (Case 1). But there is risk of macular hole formation in cases where the retina is extremely thinned out. A foveal-sparing ILM peel can be considered in such cases (Case 2). In refractory cases (Case 3), if no resolution is noted even after ≥12 months autologous ILM transplantation has been reported to be an effective treatment option.,
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Conflicts of interest
There are no conflicts of interest.
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[Figure 1], [Figure 2], [Figure 3]