Optic disc pits are a rare but significant anomaly of the optic nerve head that can lead to visual impairment and associated complications. These pits are characterized by a small, oval-shaped depression in the disc, which can cause fluid accumulation and subsequent damage to the adjacent retina. Although the etiology and pathogenesis of optic disc pits are not fully understood, several theories have been proposed, including abnormal embryonic development and degenerative changes. Diagnosis is typically made through a comprehensive eye examination, including a dilated fundus exam and optical coherence tomography. Management options vary depending on the severity of the condition and associated complications, ranging from observation to surgical intervention.

OBJECTIVE: we aimed to report on the optical coherence tomography angiography (OCTA) outcomes of eight patients with optic disc pit maculopathy (ODP-M) who were treated with 23-gauge pars plana vitrectomy (PPV).
METHODS: We examined sixteen eyes of eight patients-eight eyes with ODP-M and eight healthy fellow eyes. Fundus color photography, fundus autofluorescence, fundus fluorescein angiography, optical coherence tomography (OCT), and OCTA were performed. The vascular density, choriocapillaris blood flow (CCBF), and foveal avascular zone (FAZ) were analyzed using OCTA. Moreover, the correlation between the best-corrected visual acuity (BCVA) and macular OCTA parameters was assessed.
RESULTS: Compared with the healthy fellow eyes, the eyes with ODP-M preoperatively were found to have decreased BCVA, superficial capillary plexus (SCP) vascular density (i.e., total, foveal, parafoveal, and perifoveal), deep capillary plexus (DCP) vascular density (i.e., total, parafoveal, and perifoveal), and CCBF but a significantly increased FAZ (p < 0.05). When the eyes with ODP-M were analyzed pre- and postoperatively at month 12 after surgery, the BCVA, SCP vascular density (i.e., perifoveal), and CCBF had significantly increased, and the FAZ had significantly decreased (p < 0.05). When the eyes with ODP-M were compared with the healthy fellow eyes postoperatively at month 12, the BCVA, SCP, and DCP vascular density parameters had increased, along with CCBF, and the FAZ had decreased in eyes with ODP-M, though not to the levels of the healthy fellow eyes (p < 0.05). Moreover, a positive correlation was found between the postoperative BCVA and SCP total vascular density (p < 0.05).
CONCLUSIONS: The BCVA and macular OCTA parameters improved in eyes with ODP-M at month 12 following surgery. However, the BCVA and OCTA of the eyes operated on did not reach the levels of the healthy fellow eyes, possibly due to impaired choroidal blood flow (CBF) recovery and the presence of a larger FAZ. In summary, OCTA seems to be useful for assessing qualitative and quantitative perioperative microvascular changes.

Purpose: To describe a patient with optic disc pit (ODP) maculopathy who presented with poor vision and treatment outcomes. Methods: An amniotic membrane transplantation (AMT) was performed using a bimanual technique with perfluoro-N-octane endotamponade after failure of other techniques to yield resolution of subretinal fluid (SRF). Results: Successful adhesion of the human amniotic membrane graft to the host resulted in sustained resolution of the SRF and significant improvement in visual acuity within 2 weeks. Conclusions: AMT is a viable therapeutic option for patients with vision loss associated with submacular fluid from ODPs. The bimanual technique with perfluorocarbon assistance provides the vitreoretinal surgeon with an additional technical alternative for surgical treatment of ODP maculopathy.

The purpose of this study was to investigate the short-term efficacy and safety of autologous platelet-rich plasma (a-PRP) as an adjuvant to revisional vitrectomy for refractory full-thickness macular holes (rFTMHs). We conducted a prospective, non-randomized interventional study including patients with rFTMH after a pars plana vitrectomy (PPV) with internal limiting membrane peeling and gas tamponade. We included 28 eyes from 27 patients with rFTMHs: 12 rFTMHs in highly myopic eyes (axial length greater than 26.5 mm or a refractive error greater than -6D or both); 12 large rFTMHs (minimum hole width > 400 μm); and 4 rFTMHs secondary to the optic disc pit. All patients underwent 25-G PPV with a-PRP, a median time of 3.5 ± 1.8 months after the primary repair. At the six-month follow-up, the overall rFTMH closure rate was 92.9%, distributed as follows: 11 out of 12 eyes (91.7%) in the highly myopic group, 11 out of 12 eyes (91.7%) in the large rFTMH group, and 4 out of 4 eyes (100%) in the optic disc pit group. Median best-corrected visual acuity significantly improved in all groups, in particular from 1.00 (interquartile range: 0.85 to 1.30) to 0.70 (0.40 to 0.85) LogMAR in the highly myopic group (p = 0.016), from 0.90 (0.70 to 1.49) to 0.40 (0.35 to 0.70) LogMAR in the large rFTMH group (p = 0.005), and from 0.90 (0.75 to 1.00) to 0.50 (0.28 to 0.65) LogMAR in the optic disc pit group. No intraoperative or postoperative complications were reported. In conclusion, a-PRP can be an effective adjuvant to PPV in the management of rFTMHs.

OBJECTIVE: Inverted Inner Limiting Membrane (ILM)-flap approach can fail in the treatment of Optic disc pit maculopathy (ODPM). We report a surgical technique involving human amniotic membrane (hAM) patch implant to treat unresolved ODPM after inverted (ILM)-flap technique.
METHODS: One patient with decreased visual acuity (1 LogMar) after unsuccessful inverted ILM-flap technique to treat ODPM, underwent hAM patch implant and was evaluated. A surgical approach including a 2 mm size graft patch of hAM implantation over the optic disc pit followed by fluid-air exchange was performed. A gas endotamponade was finally used. The patient was instructed to maintain face-down position for the first three days after surgery. The hAM patch remained detectable over the pit for the entire 6-months follow-up. The ODPM gradually resolved and visual acuity partially recovered to 0.17 LogMar during follow-up. No postoperative complications or recurrence were reported.
CONCLUSIONS: hAM patch implant may be effective to manage ODPM after unsuccessful inverted ILM-flap.

We report a clinical case of a serous macular detachment associated with optic disc pit (ODP), which was successfully treated with vitrectomy and internal limiting membrane (ILM) flap technique. A twenty-four-year-old woman complained of visual loss with duration over 7 months. Upon ophthalmic examination using funduscopy and spectral domain optical coherence tomography (OCT), a serous macular detachment associated with optic disc pit was diagnosed. The patient was successfully treated by 25-gauge pars plana vitrectomy with ILM peeling and placing an autologous ILM flap to cover the optic disc including the ODP. This method of treatment resulted in complete retinal reattachment with best-corrected visual acuity improvement to 20/60 from initial 20/500, and OCT showed a complete retinal attachment. This clinical case suggests that 25-gauge vitrectomy with ILM peeling and an inverted ILM flap can be an effective treatment option for optic disc pit-associated serous macular detachment.

暂无摘要。

Macular schisis is the splitting of the inner retinal layers at macula, with or without associated detachment. The acquired form of macular schisis is frequently associated with optic disc pit maculopathy, although it could be accompanied by several conditions such as tractional maculopathies, cystoid macular edema, veno-occlusive disease, and shaken baby syndrome. However, a small number of cases of retinoschisis without optic disc pit have been reported elsewhere. Here, we present a patient with acquired macular schisis without high myopia and optic disc abnormality in funduscopic examination and imaging. Macular optical coherence tomography of her left eye revealed schisis of the inner and outer retinal layers and subretinal fluid and choroidal thickness of 426 μm (pachychoroid). Although the optic disc of this patient appeared normal, the probable presumption is that small junctions existed between the macular neuroretinal tissue and the vitreous cavity. Further studies are required to survey the other probable mechanisms of retinoschisis without optic pit with more subjects.

OBJECTIVE: To share the anatomical results and visual outcomes of intravitreal gas tamponade combined with laser photocoagulation treatment for optic disc pit maculopathy (ODPM).
METHODS: Intravitreal gas tamponade combined with laser photocoagulation treatment was performed on six consecutive patients with ODPM. A 0.3 mL of 100% perfluoropropane (C3F8) gas was injected intravitreally. The patients were then asked to maintain prone position until the C3F8 gas disappeared. Laser photocoagulation was performed the day after the procedure. The outcomes were determined by spectral-domain optical coherence tomography and best-corrected visual acuity (BCVA).
RESULTS: In the present study, visual improvement and reduction in serous macular detachment were observed in 83% of the ODPM patients. Complete retinal reattachment was achieved in 66% of the ODPM patients. In one patient, no regression was observed after the repeated treatment, and pars plana vitrectomy was performed. The final BCVA improved in five eyes and unchanged in one eye. No postoperative complications were observed during the follow-up period in any patient.
CONCLUSIONS: Intravitreal C3F8 gas tamponade combined with laser photocoagulation procedure is an effective, minimally invasive, and cost-effective treatment method for ODPM.

OBJECTIVE: To evaluate a variety of techniques, and their anatomical and functional results, for the treatment of optic disc pit maculopathy (ODP-M). A secondary aim was to report on results of secondary procedures in cases of initial failure or recurrence.
METHODS: Multicentre retrospective study of 95 eyes with ODP-M, treated by 25 surgeons from 12 countries. Primary outcomes were anatomical resolution of subretinal fluid (SRF), intraretinal fluid (IRF) and visual acuity (VA) at 12 months.
RESULTS: Higher rates of SRF and IRF resorption were achieved in eyes treated with pars plana vitrectomy (PPV) compared to external laser with or without tamponade: 64/72 (88.9%) versus 8/14 (57.1%) for SRF (p = 0.003), and 50/59 (84.7%) versus 3/10 (30%) for IRF (p = 0.002). The addition of juxtapapillary laser or internal limiting membrane (ILM) peel during PPV did not improve SRF or IRF resolution. Pars plana vitrectomy (PPV) with tamponade and PPV with tamponade plus endolaser were associated with significant visual gain. In the former group, VA improved from a mean of logMAR 0.91 (20/162), to a mean of logMAR 0.52 (20/66) at 12 months; in the latter group, VA improved from a mean of logMAR 0.82 (20/132) to a mean of logMAR 0.47 (20/59) at 12 months. Retreatments were performed in 14 eyes (15.7%), only enhancing anatomical outcomes.
CONCLUSIONS: Vitrectomy with tamponade had better final outcomes than external laser treatment with or without gas tamponade. Laser endophotocoagulation and ILM peel provided no additional benefit. A secondary treatment resulted in anatomical but not functional improvement.