Spectral domain optical coherence tomography morphology in optic disc pit associated maculopathy.

Purpose: Our purpose was to study the clinical manifestation and course of optic pit maculopathy using Spectral Domain Optical Coherence Tomography (SD‐ OCT) images. Materials and Methods: We used SD‐OCT to examine 20 eyes of 19 patients with a macular detachment in combination with an optic. Results: We observed five different fovea appearances in regard to fluid localization. In five eyes, we recorded changes in the fluid distribution with SD‐OCT. In 17/20 eyes, we noted a communication between the perineural and subretinal and/or intraretinal space at the margin of the optic disc. Conclusion: 3‐dimensional SD‐OCT (3D‐SDOCT) scans revealed a three‐fold connection, between subretinal and intraretinal space, perineural space, and the vitreous cavity. Therefore, we suppose that intraretinal or subretinal fluid in optic pit maculopathy may have both a vitreous and cerebrospinal origin. A membrane, covering the optic nerve was noted in 14 cases. Even if it seems intact in some B‐scans, it is not complete in others several micrometers apart. Additionally, we observed fluid accumulation below the margin of the optic disc and hyperreflective porous tissue in the optic disc excavation. Those findings do not influence the course of maculopathy.

A Case of Serous Macular Detachment Preceding Macular Retinoschisis in an Optic Pit

PURPOSE: To report a case of serous macular detachment preceding macular retinoschisis in an optic pit patient successfully treated by vitrectomy with internal limiting membrane peeling. CASE SUMMARY: A 76 year old female visited our clinic for visual disturbance in her right eye. Fundus photograph revealed optic pit and OCT showed macular retinoschisis in her right eye. She was followed up in our clinic. The patient revisited our clinic because of sudden decrease of visual acuity in her right eye 3 days before. At that time, the patient's best-corrected visual acuity was 0.05. Macular retinoschisis, subretinal fluid and serous retinal detachment were observed in her right eye on OCT. She was diagnosed with serous retinal detachment associated with optic pit and pars plana vitrectomy was performed. During vitrectomy, we found adhesion and defect of posterior hyaloid membrane which covered the optic pit. Therefore, subretinal fluid was drained via membrane defect and posterior vitreous detachment and fluid-gas exchange were induced. Sixteen days after surgery, we found a macular hole in her right eye on OCT. Pars plana vitrectomy was performed with internal limiting membrane peeling. One month after surgery, macular detachment was not observed. Six months after surgery, the patient's best corrected visual acuity was 0.63 and the macula was reattached completely. CONCLUSIONS: Optic pit maculopathy can be progressed rapidly in aged patients and macular hole would be ocurred as a complication. Additional study will be needed to figure out the role of internal limiting membrane and tractional force of posterior vitreous in these patients.

Case of Macular Hole after Surgery in Macular Detachment with Optic Disc Pit in a Child

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.

A Case of Serous Macular Detachment Associated with Tractional Fibrous Tissue in an Optic Pit Patient

PURPOSE: To report a case of serous macular detachment associated with tractional fibrous tissue in an optic pit patient successfully treated by vitrectomy without laser photocoagulation. CASE SUMMARY: A 15-year-old female visited our hospital for visual disturbance of her left eye. The patient's best-corrected visual acuity was 0.5. After ophthalmic examinations, the patient was diagnosed with an optic pit associated serous macular detachment. Pars plana vitrectomy with complete posterior vitreous detachment was performed. A thick fibrous tissue within the optic disc cupping was found. During removal of the fibrous tissue, the tissue was observed to be attached to a tiny hole above the optic pit. The thick fibrous tissue was tugging at the margin of the hole and was removed using intraocular forceps to relieve the traction. Fluid-gas exchange was then performed and the operation was completed without laser photocoagulation around the optic disc. The fovea was reattached completely in 12 months and visual acuity was improved to 0.8.