ABSTRACT
La foseta papilar es una rara anomalía congénita que forma parte del espectro de las anormalidades congénitas del disco óptico. Se trata de invaginaciones intrapapilares que suelen localizarse en el margen del disco óptico. La mayoría se localiza a nivel temporal; en torno al 20 por ciento son de localización central seguidas por las fosetas superiores, inferiores o nasales. La bilateralidad se estima en un 10-15 por ciento y su incidencia se ha establecido en torno al 0,19 por ciento. Suelen ser asintomáticas, aunque en aproximadamente el 50 por ciento de los casos se produce afectación macular por el paso de fluido procedente desde la foseta papilar hacia las diferentes capas retinianas, lo que afecta secundariamente la agudeza visual y es, por tanto, el motivo de consulta. Hasta el momento se han descrito múltiples alternativas terapéuticas para el tratamiento de los desprendimientos de retina serosos asociados a foseta de papila, pero ninguna de estas alternativas se ha impuesto sobre el resto. El tratamiento de esta enfermedad consiste en cerrar la comunicación entre la foseta y el espacio subretiniano con diversas opciones terapéuticas como: la fotocoagulación láser, la neumoretinopexia, la indentación escleral posterior, la fenestración del nervio óptico, la vitrectomía o alguna combinación de las anteriores. La actual revisión bibliográfica se propone profundizar en el tema, sobre la base de pacientes en consulta con dicha afección retiniana(AU)
Papillary pit is a rare congenital anomaly that is part of the congenital optic disc anomaly spectrum. It deals with intrapapillary invaginations that may be located at the border of the optic disc. Most of them is located at temporal level, around 20 percent are located centrally followed by upper, lower and nasal pits. Bilateral pits are estimated to be 10-15 percent and their incidence has been set at 0.19 percent. They are asymptomatic although 50 percent of cases suffer macular damage due to the passing of fluid from the papillary pit to the different retinal layers, which affecgs in a secondary way the visual acuity and thus it is the reason to go to the ophthalmologist. Multiple therapeutic alternatives for the treatment of papillary pit-associated serous retinal detachments have been described but none of them has predominated over the others. The treatment of this disease consists of closing the communication between the pit and the subretinal space with several therapeutic options such as laser photocoagulation, pneumoretinopexia, posterior scleral indentation, optic nerve fenestration, vitrectomy or any combination of the above-mentioned methods(AU)
Subject(s)
Humans , Coloboma/physiopathology , Databases, Bibliographic , Optic Disk/abnormalities , Retinal Detachment/therapy , Review Literature as Topic , Laser Coagulation/adverse effects , Vitrectomy/adverse effectsABSTRACT
PURPOSE: To report a case of macular hole after surgery in macular serous detachment associated with optic disc pit in a child, which was treated with silicone oil as an intraocular substitute. CASE SUMMARY: A 12-year-old boy was referred for examination due to visual disturbance in his left eye for the last 1 week. Corrected visual acuity at presentation was 0.08 in the left eye. The anterior part of the left eye was normal on slit lamp examination. Funduscopic examination revealed optic disc pit associated with macular detachment. The patient was treated with vitrectomy, internal limiting membrane (ILM) peeling and gas tamponade. One week after treatment, the patient presented with central visual disturbance and showed a full thickness macular hole in the left eye. Extensive ILM peeling and silicone oil instillation were performed and after 2 months, silicone oil removal was performed. The macular hole appeared to be closed and visual acuity improved to 0.2. Recurrence was not observed until 20 months after treatment. CONCLUSIONS: After surgical treatment due to macular detachment associated with optic disc pit in a child, occurrence of a macular hole is possible. Regarding macular hole treatment, silicone oil instillation and fast removal could be a beneficial option.