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Wan R, Chang A. Optic disc pit maculopathy: a review of diagnosis and treatment. Clin Exp Optom 2019; 103:425-429. [PMID: 31441129 DOI: 10.1111/cxo.12957] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Revised: 06/23/2019] [Accepted: 07/26/2019] [Indexed: 12/16/2022] Open
Abstract
Optic disc pit is a rare congenital defect which appears as a circumscribed greyish depression in the lamina cribrosa. Serous macular detachment is one of the most visually debilitating complications of optic disc pit, affecting 25-75 per cent of patients. Although there is a wide variety of treatment modalities available with varying degrees of success, there is yet no consensus in the optimal management of optic disc pit-associated maculopathy. This review discusses the literature on the pathogenesis, clinical presentation, diagnosis and treatment options.
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Affiliation(s)
- Ran Wan
- Sydney Retina Clinic & Day Surgery, Sydney, Australia
| | - Andrew Chang
- Sydney Retina Clinic & Day Surgery, Sydney, Australia.,Sydney Eye Hospital, Sydney, Australia.,The University of Sydney, Sydney, Australia
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52
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Starosta DA, Lorenz B. [Minimal Variant of an Optic Disc Pit with Cecocentral Scotoma Due to Limited Progressive Retinal Ganglion Cell Atrophy - a Case Report]. Klin Monbl Augenheilkd 2019; 238:1130-1133. [PMID: 31266071 DOI: 10.1055/a-0901-7582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Daniela Aneta Starosta
- Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Gießen und Marburg GmbH, Gießen
| | - Birgit Lorenz
- Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Gießen und Marburg GmbH, Gießen
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Iftikhar M, Shah SMA, Goldberg MF. A Case of Optic Disc Pit Maculopathy Observed without Intervention for 6 Years. Ophthalmol Retina 2019; 3:195-197. [PMID: 31014772 DOI: 10.1016/j.oret.2018.09.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 09/20/2018] [Accepted: 09/24/2018] [Indexed: 11/26/2022]
Affiliation(s)
- Mustafa Iftikhar
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Syed M A Shah
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Morton F Goldberg
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland.
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54
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Pastor-Idoate S, Gómez-Resa M, Karam S, Copete S, Kyriakou D, García-Arumí Fusté C, Pastora N, Nadal J, García-Arumí J. Efficacy of Internal Limiting Membrane Flap Techniques with Vitrectomy for Macular Detachment Associated with an Optic Disc Pit. Ophthalmologica 2019; 242:38-48. [DOI: 10.1159/000495621] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 11/19/2018] [Indexed: 11/19/2022]
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Modi A, Mehta RA, Yadav NK. Active Cone Regeneration Following Autologous Internal Limiting Membrane 'Chunk' Transplantation in Optic Disc Pit-Associated Maculopathy. Ophthalmic Surg Lasers Imaging Retina 2019; 49:152-155. [PMID: 29443368 DOI: 10.3928/23258160-20180129-13] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 12/04/2017] [Indexed: 12/12/2022]
Abstract
This case report aims to study active cone regeneration and its functional correlation in optic disc pit maculopathy (ODPM) with a large outer macular defect treated with autologous internal limiting membrane (ILM) "chunk" transplantation. Outcome analysis was done using spectral-domain optical coherence tomography (SD-OCT), adaptive optics, and microperimetry. Visual acuity improved from counting fingers at 2 meters to 6/18 Snellen equivalent postoperatively, whereas SD-OCT demonstrated closure of outer subfoveal defect. Adaptive optics imaging revealed maximum active cone concentration of 14,232/mm2 at the fovea, and fixation stability improved to 61% and 90% (P1 and P2, respectively) on microperimetry. To conclude, autologous ILM "chunk" transplantation provides an additional therapeutic option in treatment of ODPM with large outer macular defect. [Ophthalmic Surg Lasers Imaging Retina. 2018;49:152-155.].
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56
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Fortune B, Ma KN, Gardiner SK, Demirel S, Mansberger SL. Peripapillary Retinoschisis in Glaucoma: Association With Progression and OCT Signs of Müller Cell Involvement. Invest Ophthalmol Vis Sci 2019; 59:2818-2827. [PMID: 29860466 PMCID: PMC5983909 DOI: 10.1167/iovs.18-24160] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Purpose To examine demographic and clinical factors associated with glaucomatous peripapillary retinoschisis (PPRS) and assess its association with glaucoma progression. Methods Using a case control study design and longitudinal data from a cohort of 166 subjects with a diagnosis of glaucoma or glaucoma suspect, we compared functional, structural, clinical, and demographic characteristics between PPRS cases and controls. Results The frequency of PPRS was 6.0% (12 eyes from 10/166 subjects) with two eyes having PPRS in different sectors for a total of 15 retinoschisis events. There were no significant differences (P > 0.05) in age, sex, visual acuity, central corneal thickness, intraocular pressure, or presence of vitreous adhesion between PPRS and controls. However, eyes with PPRS tended to have a higher cup-to-disc ratio (P = 0.06), thinner RNFL (P = 0.02), and worse visual field mean deviation (MD, P = 0.06) than controls. The rate of RNFL thinning was faster in PPRS (average: −2.8%/year; range: −7.4% to 0.0%/year) than controls (−1.3%/year; range: −4.4% to 0.6%/year; P = 0.021). The rate of visual field MD change was faster in PPRS (−0.49 dB/year; range: −2.0 to 0.9 dB/year) than controls (−0.06 dB/year; range: −0.8 to 0.3 dB/year; P = 0.030). OCT scans showed hyperreflective structures spanning the PPRS whose morphology and spacing (50 ± 7 μm) are consistent with Müller glia, causing signal attenuation casting “shadows” onto distal retina. Conclusions This is the first report showing that glaucomatous PPRS is associated with a faster overall rate of RNFL thinning and visual field deterioration and to specifically identify OCT signs of Müller cell involvement.
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Affiliation(s)
- Brad Fortune
- Discoveries in Sight Research Laboratories, Devers Eye Institute and Legacy Research Institute, Legacy Health, Portland, Oregon, United States
| | - Kelly N Ma
- Northwest Permanente, Portland, Oregon, United States
| | - Stuart K Gardiner
- Discoveries in Sight Research Laboratories, Devers Eye Institute and Legacy Research Institute, Legacy Health, Portland, Oregon, United States
| | - Shaban Demirel
- Discoveries in Sight Research Laboratories, Devers Eye Institute and Legacy Research Institute, Legacy Health, Portland, Oregon, United States
| | - Steven L Mansberger
- Discoveries in Sight Research Laboratories, Devers Eye Institute and Legacy Research Institute, Legacy Health, Portland, Oregon, United States
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57
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Uzel MM, Karacorlu M. Optic disk pits and optic disk pit maculopathy: A review. Surv Ophthalmol 2019; 64:595-607. [PMID: 30797884 DOI: 10.1016/j.survophthal.2019.02.006] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 02/05/2019] [Accepted: 02/11/2019] [Indexed: 11/19/2022]
Abstract
Optic disk pit, one of the optic disk cavitary anomalies, is generally congenital and unilateral and occurs equally in males and females. Optic disk pit maculopathy is characterized by intraretinal and subretinal fluid at the macula, causing visual deterioration. The origin of the macular fluid and the mechanism of transition to the subretinal space in optic disk pit maculopathy pathophysiology are not yet fully understood. With the evolution of imaging modalities, especially optic coherence tomography, our knowledge of this disorder continues to increase. Although many different treatments have been tried, there is no consensus on the most effective.
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58
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Watanabe T, Kasahara K, Futagami S, Fang Y, Du R, Moriyama M, Uramoto K, Yokoi T, Onishi Y, Yoshida T, Kamoi K, Jonas JB, Ohno-Matsui K. Cilioretinal Arteries and Cilioretinal Veins in Eyes with Pathologic Myopia. Sci Rep 2019; 9:2451. [PMID: 30792400 PMCID: PMC6384956 DOI: 10.1038/s41598-019-38616-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 01/04/2019] [Indexed: 11/17/2022] Open
Abstract
We investigated the clinical characteristics of cilioretinal arteries (CAs) and cilioretinal veins (CVs) in eyes with pathologic myopia. Ninety-five eyes with pathologic myopia and CAs were studied. The retrobulbar vessels from which the CAs originated were identified by indocyanine green angiography (ICGA). The results showed that 114 CAs were identified in the 95 eyes. ICGA showed that 60% of the CAs branched directly off the short posterior ciliary arteries (SPCAs) and 40% originated from the Zinn-Haller arterial circle (ZHAC). The SPCA-derived CAs tended to be located superiorly and served a large retinal area whereas the ZHAC-associated CAs tended to be located temporally and served mainly the macular area. In 15% of the 95 eyes, the CVs were observed to run parallel to the CAs. The CVs exited the eye at the same point where the CAs entered the eye. This study showed that CAs in eyes with pathologic myopia can be divided into those that are SPCA-derived and tend to emerge in the superior optic disc sector, and those that are ZHAC-associated and usually emerge temporally. An elongating peripapillary scleral flange in eyes with progressive axial myopia may lead to a change of chorioretinal vascular system.
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Affiliation(s)
- Takashi Watanabe
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan.,Department of Ophthalmology, Tokyo Metropolitan Health and Medical Treatment Corporation Tama-Nanbu Chiiki Hospital, Tokyo, Japan
| | - Kaori Kasahara
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Soh Futagami
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan.,Department of Ophthalmology, Nissan Tamagawa Hospital, Tokyo, Japan
| | - Yuxin Fang
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ran Du
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Muka Moriyama
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kengo Uramoto
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tae Yokoi
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yuka Onishi
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takeshi Yoshida
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Koju Kamoi
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Jost B Jonas
- Department of Ophthalmology, Medical Faculty Mannheim of the Ruprecht-Karls-University Heidelberg, Seegartenklinik Heidelberg, Germany
| | - Kyoko Ohno-Matsui
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan.
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59
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Gambrelle J, Bathany D, Robinet A, Bobo C, Grange JD. [Optic disc pit combined with interpapillo-macular ganglion cells hypoplasia]. J Fr Ophtalmol 2019; 42:e67-e68. [PMID: 30685116 DOI: 10.1016/j.jfo.2018.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Accepted: 05/24/2018] [Indexed: 11/19/2022]
Affiliation(s)
| | - D Bathany
- Clinique Pasteur, 29200 Brest, France
| | - A Robinet
- Clinique Pasteur, 29200 Brest, France
| | - C Bobo
- Clinique Pasteur, 29200 Brest, France
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60
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Soibam R, Bhat PA, Barman M, Bhattacharjee H, Nisa AU. Surgical outcome in optic disc pit maculopathy. Oman J Ophthalmol 2018; 11:294-296. [PMID: 30505129 PMCID: PMC6219328 DOI: 10.4103/ojo.ojo_17_2017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The purpose of this study was to present the surgical outcome in optic disc pit associated maculopathy in a patient who was treated with vitrectomy, internal limiting membrane (ILM) peeling, barrage laser photocoagulation, and silicone oil tamponade. A 21-year-old Indian male was diagnosed with optic disc pit maculopathy in his left eye with a best-corrected visual acuity (BCVA) of 20/200. A 23-gauge pars plana vitrectomy with peeling of ILM was done using brilliant blue dye. After completion of vitrectomy, fluid-air exchange was performed and silicone oil was instilled into eye. Peripapillary endolaser barrage photocoagulation using two rows of low-intensity laser was performed temporally. Silicone oil was removed 4 months after surgery. During the next 24 months, the retina gradually flattened with gradual improvement of BCVA in the left eye. At 24 months, fundus examination showed retinal pigment epithelium atrophy temporal to optic disc not involving the fovea, and optical coherence tomography showed complete resolution of subretinal fluid, with a BCVA of 20/60. The patient maintained the same vision 4 years following the surgery. vitrectomy combined with posterior hyaloid and ILM peeling followed by silicone oil tamponade, with additional laser photocoagulation, was successful for the treatment of optic disc pit maculopathy in our patient. Further studies are warranted to explore the various treatment options and try to set a standard treatment protocol for this rare challenging condition.
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Affiliation(s)
- Ronel Soibam
- Vitreoretinal Services, Sri Sankaradeva Nethralaya, Guwahati, Assam, India
| | - Parvez Ahmad Bhat
- Vitreoretinal Services, Sri Sankaradeva Nethralaya, Guwahati, Assam, India
| | - Manabjyoti Barman
- Vitreoretinal Services, Sri Sankaradeva Nethralaya, Guwahati, Assam, India
| | | | - Arsalan Un Nisa
- Department of Ophthalmology, Government Medical College, Srinagar, Jammu and Kashmir, India
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61
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Almeida DRP, Chin EK, Arjmand P, Velez G, Evans LP, Mahajan VB. Fibrin Glue and Internal Limiting Membrane Abrasion for Optic Disc Pit Maculopathy. Ophthalmic Surg Lasers Imaging Retina 2018; 49:e271-e277. [PMID: 30566713 PMCID: PMC10887125 DOI: 10.3928/23258160-20181203-18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2017] [Accepted: 05/02/2018] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND OBJECTIVE To describe a novel surgical technique using pars plana vitrectomy (PPV), internal limiting membrane (ILM) abrasion, and intravitreal fibrin glue for the treatment of optic disc pit maculopathy. PATIENTS AND METHODS Surgical case series technique with scanning electron microscopy (SEM) of human post-mortem eyes. RESULTS Using SEM, the authors demonstrate the persistent adherence of vitreous fragments to the optic disc following induction of posterior vitreous detachment in human postmortem eyes. The authors describe a surgical technique using PPV, Tano Diamond Dusted Membrane Scraper for an ILM abrasion, intravitreal fibrin glue (Tisseel), and gas-air exchange to seal optic disc pits. The authors report successful long-term visual and anatomical outcomes in three patients. CONCLUSIONS Intravitreal fibrin glue, when combined with ILM abrasion, may be a viable treatment option for optic disc pit maculopathy with good short- and long-term visual acuity outcomes. SEM shows that ILM abrasion removes vitreous fragments, which are persistently adherent and may lead to failure with other interventional techniques. [Ophthalmic Surg Lasers Imaging Retina. 2018;49:e271-e277.].
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Caporossi T, Finocchio L, Barca F, Franco F, Tartaro R, Rizzo S. 27-Gauge Via Pars Plana Vitrectomy With Autologous ILM Transplantation for Optic Pit Disc Maculopathy. Ophthalmic Surg Lasers Imaging Retina 2018; 49:712-714. [DOI: 10.3928/23258160-20180831-10] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Accepted: 08/03/2018] [Indexed: 11/20/2022]
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63
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Chatziralli I, Theodossiadis P, Theodossiadis GP. Optic disk pit maculopathy: current management strategies. Clin Ophthalmol 2018; 12:1417-1422. [PMID: 30127591 PMCID: PMC6089607 DOI: 10.2147/opth.s153711] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Optic disk pit (ODP) is a rare congenital abnormality of the optic nerve head and can lead to visual impairment when macular detachment occurred. Recent advances in retinal imaging brought new insights into the pathophysiology of the disease, while new therapeutic options have been also described. Methods We made a comprehensive search of the literature regarding the current treatment modalities for the treatment of ODP maculopathy. Results Although there have been reported some cases of spontaneous resolution, current management of ODP maculopathy involves several surgical approaches. The most commonly used treatment alternative for ODP maculopathy management is vitrectomy, either alone or in combination with other treatment modalities, such as gas tamponade or laser photocoagulation. Other options, such as scleral buckling and inner fenestration, are also used, based on the recent findings about pathophysiology of the disease. Conclusion The management of ODP maculopathy remains challenging. Even though there are further advances in the understanding of the disease pathophysiology, the applied treatment is not single and therapeutic modalities differ in the success rate, related to the anatomical and functional results.
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Affiliation(s)
- Irini Chatziralli
- 2nd Department of Ophthalmology, University of Athens, Attikon Hospital, Athens, Greece,
| | | | - George P Theodossiadis
- 2nd Department of Ophthalmology, University of Athens, Attikon Hospital, Athens, Greece,
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Steel DHW, Suleman J, Murphy DC, Song A, Dodds S, Rees J. Optic Disc Pit Maculopathy: A Two-Year Nationwide Prospective Population-based Study. Ophthalmology 2018; 125:1757-1764. [PMID: 29887331 DOI: 10.1016/j.ophtha.2018.05.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Revised: 05/02/2018] [Accepted: 05/07/2018] [Indexed: 10/14/2022] Open
Abstract
PURPOSE To identify the incidence, presenting features, treatment, and clinical course of optic disc pit maculopathy (ODPM) in the United Kingdom (UK). DESIGN A 2-year nationwide prospective population-based study. SUBJECTS All new incident cases of ODPM presenting to UK ophthalmologists using the British Ophthalmic Surveillance Unit monthly reporting system. METHODS All reporting ophthalmologists were sent an initial questionnaire requesting data on previous medical and ophthalmic history, presentation details, investigation findings, and management. A further questionnaire was sent at 12 months post diagnosis to ascertain further outcome data. MAIN OUTCOME MEASURES Visual acuity at initial presentation, at 1 year, and after any intervention. Foveal involvement and optical coherence tomography (OCT) findings, including retinal layers affected, and the location and size of the optic disc pit. Management, including observation, vitrectomy, and associated procedures. RESULTS There were 74 confirmed new cases, giving an annual incidence of approximately 1 per 2 million. Complete data were available on 70 patients (70 eyes) at baseline and 68 after 1 year. There were 35 (50%) female patients with a mean age of 35 years (range, 3-82 years). Visual acuity at baseline ranged from 6/5 to hand movements. In 43 patients (61%) subretinal fluid (SRF) was present, whereas 27 (39%) had intraretinal fluid only. The presence of SRF was associated with worse vision and foveal involvement. Of the 53 eyes initially observed with 1-year follow-up, 10 (19%) deteriorated and 9 (16%) improved on OCT; eyes with SRF were more likely to worsen and those without SRF were more likely to improve. Fifteen of the 70 patients (21%) at baseline had primary surgery and a further 10 had deferred surgery within 1 year of presentation; 19 of these 25 eyes (76%) showed anatomic success with a dry fovea at 1 year of follow-up, and 15 (60%) had a greater than 0.1 logMAR improvement in visual acuity. CONCLUSION The incidence and presenting features of ODPM were defined. Patients with SRF had worse vision and were more likely to deteriorate than patients with intraretinal fluid only. Surgery was anatomically successful in 75% of cases. Patients without SRF tended to remain stable with observation.
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Affiliation(s)
- David H W Steel
- Sunderland Eye Infirmary, Sunderland, United Kingdom; Institute of Genetic Medicine, Newcastle University, Newcastle Upon Tyne, United Kingdom.
| | - Javid Suleman
- Sunderland Eye Infirmary, Sunderland, United Kingdom
| | - Declan C Murphy
- Institute of Genetic Medicine, Newcastle University, Newcastle Upon Tyne, United Kingdom
| | - Anna Song
- Institute of Genetic Medicine, Newcastle University, Newcastle Upon Tyne, United Kingdom
| | - Steve Dodds
- Sunderland Eye Infirmary, Sunderland, United Kingdom
| | - Jon Rees
- School of Psychology, Faculty of Health Sciences and Well Being, University of Sunderland, Sunderland, United Kingdom
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65
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Role of the Epipapillary Membrane in Maculopathy Associated with Cavitary Optic Disc Anomalies: Morphology, Surgical Outcomes, and Histopathology. J Ophthalmol 2018; 2018:5680503. [PMID: 29854427 PMCID: PMC5964424 DOI: 10.1155/2018/5680503] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2017] [Accepted: 03/15/2018] [Indexed: 11/18/2022] Open
Abstract
Purpose To evaluate the surgical outcomes of pars plana vitrectomy (PPV) with epipapillary membrane removal in patients with maculopathy associated with cavitary optic disc anomalies. Methods Eight patients (8 eyes) with cavitary optic disc anomaly-associated maculopathy who underwent PPV with epipapillary membrane removal were retrospectively reviewed. The best-corrected visual acuity (BCVA) and macular and papillary morphologies using enhanced depth imaging optical coherence tomography (EDI-OCT) were evaluated before and after treatment. Immunohistochemistry for an intraoperatively excised epipapillary membrane tissue was also performed. Results Before surgery, EDI-OCT revealed that epipapillary membrane was observed in all patients. Retinoschisis was resolved with no recurrence in all patients following vitrectomy regardless of a disease type or the presence or absence of preoperative posterior vitreous detachment. The mean final BCVA and central retinal thickness significantly improved compared with pretreatment values (P = 0.008 and 0.004, resp.). Immunoreactivity for S100 protein and glial fibrillary acidic protein, markers of astrocytes, was positive in the resected membrane tissues. Conclusions These results suggest that epipapillary membrane is involved in the pathogenesis of some patients with cavitary optic disc anomaly-associated maculopathy as well as posterior hyaloid membrane. PPV with epipapillary membrane removal may be a useful treatment option for this maculopathy. This trial is registered with UMIN000011123.
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66
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Maertz J, Kolb JP, Klein T, Mohler KJ, Eibl M, Wieser W, Huber R, Priglinger S, Wolf A. Combined in-depth, 3D, en face imaging of the optic disc, optic disc pits and optic disc pit maculopathy using swept-source megahertz OCT at 1050 nm. Graefes Arch Clin Exp Ophthalmol 2017; 256:289-298. [PMID: 29238852 PMCID: PMC5790839 DOI: 10.1007/s00417-017-3857-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Revised: 10/25/2017] [Accepted: 11/21/2017] [Indexed: 11/25/2022] Open
Abstract
Purpose To demonstrate papillary imaging of eyes with optic disc pits (ODP) or optic disc pit associated maculopathy (ODP-M) with ultrahigh-speed swept-source optical coherence tomography (SS-OCT) at 1.68 million A-scans/s. To generate 3D-renderings of the papillary area with 3D volume-reconstructions of the ODP and highly resolved en face images from a single densely-sampled megahertz-OCT (MHz-OCT) dataset for investigation of ODP-characteristics. Methods A 1.68 MHz-prototype SS-MHz-OCT system at 1050 nm based on a Fourier-domain mode-locked laser was employed to acquire high-definition, 3D datasets with a dense sampling of 1600 × 1600 A-scans over a 45° field of view. Six eyes with ODPs, and two further eyes with glaucomatous alteration or without ocular pathology are presented. 3D-rendering of the deep papillary structures, virtual 3D-reconstructions of the ODPs and depth resolved isotropic en face images were generated using semiautomatic segmentation. Results 3D-rendering and en face imaging of the optic disc, ODPs and ODP associated pathologies showed a broad spectrum regarding ODP characteristics. Between individuals the shape of the ODP and the appending pathologies varied considerably. MHz-OCT en face imaging generates distinct top-view images of ODPs and ODP-M. MHz-OCT generates high resolution images of retinal pathologies associated with ODP-M and allows visualizing ODPs with depths of up to 2.7 mm. Conclusions Different patterns of ODPs can be visualized in patients for the first time using 3D-reconstructions and co-registered high-definition en face images extracted from a single densely sampled 1050 nm megahertz-OCT (MHz-OCT) dataset. As the immediate vicinity to the SAS and the site of intrapapillary proliferation is located at the bottom of the ODP it is crucial to image the complete structure and the whole depth of ODPs. Especially in very deep pits, where non-swept-source OCT fails to reach the bottom, conventional swept-source devices and the MHz-OCT alike are feasible and beneficial methods to examine deep details of optic disc pathologies, while the MHz-OCT bears the advantage of an essentially swifter imaging process. Electronic supplementary material The online version of this article (10.1007/s00417-017-3857-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Josef Maertz
- Augenklinik der Ludwig-Maximilians-Universität München, Campus Innenstadt, Mathildenstraße 8, D-80336, Munich, Germany
| | - Jan Philip Kolb
- Lehrstuhl für BioMolekulare Optik, Fakultät für Physik, Ludwig-Maximilians-Universität München, Munich, Germany
- Institut für Biomedizinische Optik, Universität zu Lübeck, Lübeck, Germany
| | - Thomas Klein
- Lehrstuhl für BioMolekulare Optik, Fakultät für Physik, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Kathrin J Mohler
- Lehrstuhl für BioMolekulare Optik, Fakultät für Physik, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Matthias Eibl
- Institut für Biomedizinische Optik, Universität zu Lübeck, Lübeck, Germany
| | - Wolfgang Wieser
- Lehrstuhl für BioMolekulare Optik, Fakultät für Physik, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Robert Huber
- Lehrstuhl für BioMolekulare Optik, Fakultät für Physik, Ludwig-Maximilians-Universität München, Munich, Germany
- Institut für Biomedizinische Optik, Universität zu Lübeck, Lübeck, Germany
| | - Siegfried Priglinger
- Augenklinik der Ludwig-Maximilians-Universität München, Campus Innenstadt, Mathildenstraße 8, D-80336, Munich, Germany
| | - Armin Wolf
- Augenklinik der Ludwig-Maximilians-Universität München, Campus Innenstadt, Mathildenstraße 8, D-80336, Munich, Germany.
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Makdoumi K, Nilsson TK, Crafoord S. Levels of beta-trace protein in optic disc pit with macular detachment. Acta Ophthalmol 2017; 95:815-819. [PMID: 28926186 PMCID: PMC5763357 DOI: 10.1111/aos.13527] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Accepted: 06/07/2017] [Indexed: 12/28/2022]
Abstract
Background To report beta‐trace protein (βTP) levels in the subretinal fluid (SRF) of four patients with a macular detachment associated with optic disc pit (ODP). Methods Four patients with a serous retinal detachment involving the macula was operated by pars plana vitrectomy (PPV) with C2F6 gas tamponade and peeling of internal limiting membrane (ILM). Patients with a follow‐up period exceeding one year postoperatively were included in the study. The SRF was drained using a fine cannula without laser photocoagulation, and the samples were analysed using particle‐enhancing nephelometry. The levels of βTP were compared to 20 routine cerebrospinal fluid (CSF) samples. Results In four of the five samples from SRF had relatively low βTP levels, with a mean concentration of 6.6 mg/l (range 2.0 to 23.1 mg/l) compared to 16.0 mg/l (range 6.3‐26.8 mg/l) in CSF. The only SRF sample within the range corresponding to normal CSF was the first sample from patient 4, and the analysis of the renewed aspirate during the second operation was 2.8 mg/l. Postoperatively, the regression of SRF was slow, but regression of SRF in the foveal region took place in all cases; however, visual acuity (VA) was improved in only half of the patients. Conclusion The results from the analysed SRF regarding βTP concentration in these patients indicate that the SRF in ODP is not identical to CSF, as the concentrations of βTP differ.
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Affiliation(s)
- Karim Makdoumi
- Faculty of Medicine and Health; Department of Ophthalmology; Örebro University; Örebro Sweden
| | - Torbjörn K. Nilsson
- Department of Medical Biosciences/Clinical Chemistry; Umeå University; Umeå Sweden
- Faculty of Medicine and Health; Department of Biomedicine; Örebro University; Örebro Sweden
| | - Sven Crafoord
- Faculty of Medicine and Health; Department of Ophthalmology; Örebro University; Örebro Sweden
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Congenital anomalies of the optic disc: insights from optical coherence tomography imaging. Curr Opin Ophthalmol 2017; 28:579-586. [PMID: 28817389 DOI: 10.1097/icu.0000000000000425] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Congenital anomalies of the optic nerve are rare but significant causes of visual dysfunction in children and adults. Accurate diagnosis is dependent on a thorough funduscopic examination, but can be enhanced by imaging information garnered from optical coherence tomography (OCT). We review common congenital optic nerve anomalies, including optic disc pit, optic nerve coloboma, morning glory disc anomaly, and hypoplasia of the optic nerve, review their systemic associations, and discuss insights from OCT imaging. RECENT FINDINGS Optic disc pits are a result of a defect in the lamina cribrosa and abnormal vitreomacular adhesions have been shown to cause maculopathy. In patients with optic nerve colobomas, OCT can be instrumental in diagnosing choroidal neovascularization, a rare but visually devastating complication. The pathogenesis of morning glory disc anomaly has been more clearly elucidated by OCT as occurring from a secondary postnatal mesenchymal abnormality rather than only the initial neuroectodermal dysgenesis of the terminal optic stalk in isolation. OCT studies of optic nerve hypoplasia have demonstrated significant thinning of the inner and outer retinal layers of the perifoveal region and thicker layers in the fovea itself, resulting in a foveal hypoplasia-like pathology, that is, significantly correlated to poorer visual outcomes. SUMMARY OCT provides detailed in-vivo analysis of these anatomic anomalies and their resulting pathologies, shedding new insights on the pathogenesis, diagnosis, and potential visual outcomes of these conditions in children. Further study employing OCT to elucidate structure-function relationships of congenital optic nerve anomalies will help expand the role of OCT in clinical practice related to diagnosis, prognosis, and management of these entities.
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Abstract
PURPOSE To evaluate the efficacy of vitrectomy in the treatment of macular retinoschisis without a detectable optic disk pit. METHODS This retrospective interventional case series included eight patients with acquired, unilateral macular retinoschisis with or without foveal detachment. Patients with an optic disk pit, vitreomacular traction, or high myopia were excluded. Six of the eight patients underwent vitrectomy with internal limiting membrane peeling and fluid-air exchange. The surgical outcome was evaluated in terms of the improvement in the macular anatomy and the best-corrected visual acuity. RESULTS During vitrectomy, all the six eyes were confirmed to have preexisting posterior vitreous detachment. Macular retinoschisis was resolved or reduced in all the six eyes after vitrectomy. The mean central foveal thickness showed significant improvement at the time of the patient's final visit after vitrectomy. The mean best-corrected visual acuity was 20/52 before surgery and 20/31 at the final visit. CONCLUSION Vitrectomy might be effective for the treatment of macular retinoschisis without an optic disk pit. Although clinically similar to optic pit maculopathy except for the absence of pit, our intraoperative observations of the posterior hyaloid membrane suggest that maculopathy without optic disk pit has a distinct pathogenesis.
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Abstract
PURPOSE To investigate the structural changes of intrapapillary proliferations associated with optic disk pits (ODPs) and optic disk pit maculopathy (ODP-M) using enhanced depth-spectral domain-optical coherence tomography (SD-EDI-OCT) and megahertz optical coherence tomography (MHz-OCT). METHODS Sixteen eyes of patients with ODPs were studied. Papillary and peripapillary areas were repeatedly examined with SD-EDI-OCT over time. To evaluate swept-source OCT, some of the patients additionally received MHz-OCT-imaging. RESULTS MHz-OCT or SD-EDI images showed the entire form of the pits from opening to bottom in 13 of the 16 cases. The shape of ODPs varied considerably. In patients with unilateral ODP, deep intrapapillary depressions in the optic disk of the contralateral partner eye were a prevalent finding. Intrapapillary proliferations were observed in all ODP-cases during follow-up. The aspect of intrapapillary and prepapillary tissue, septae, and cavities changed over time. This effect was especially pronounced inside the ODP while the eye experienced simultaneous ODP-M. CONCLUSION All examined eyes with ODP showed signs of intrapapillary and prepapillary tissue, which developed over time. SD-EDI-OCT and MHz-OCT are able to detect characteristic ODP-related findings and are a useful means to monitor time-related changes within intrapapillary and prepapillary tissue related to ODP and ODP-M.
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Nair AG, Kaliki S, Mishra DK, Naik MN. Unilateral optic disc pit associated with orbital cyst in a child. Saudi J Ophthalmol 2017; 31:190-192. [PMID: 28860922 PMCID: PMC5569357 DOI: 10.1016/j.sjopt.2017.05.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2017] [Revised: 05/22/2017] [Accepted: 05/26/2017] [Indexed: 11/17/2022] Open
Abstract
Optic disc pit and disc coloboma are common congenital anomalies. Both have been known to be associated with an orbital cyst. We report a case of a 6 month-old child who presented with unilateral progressive proptosis. Imaging investigations revealed a well-defined, intraconal, orbital cyst located close to the posterior surface of the globe displacing the optic nerve laterally. The cyst was excised and histopathological examination showed the cyst to have a lining of glial tissue, a thin epithelial lining, over a layer of collagenous connective tissue matrix. We hypothesize that colobomatous disc abnormalities and optic disc pits are different points on the same disease spectrum and can be associated with orbital cysts. Furthermore, our case points to the possible role of imaging the optic nerve in all cases of optic disc anomalies.
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Affiliation(s)
- Akshay Gopinathan Nair
- The Operation Eyesight Universal Institute of Eye Cancer, L V Prasad Eye Institute, Banjara Hills Road Number 2, Hyderabad 500 034, India
| | - Swathi Kaliki
- The Operation Eyesight Universal Institute of Eye Cancer, L V Prasad Eye Institute, Banjara Hills Road Number 2, Hyderabad 500 034, India
| | - Dilip Kumar Mishra
- Ophthalmic Pathology Service, L V Prasad Eye Institute, Banjara Hills Road Number 2, Hyderabad 500 034, India
| | - Milind N Naik
- The Operation Eyesight Universal Institute of Eye Cancer, L V Prasad Eye Institute, Banjara Hills Road Number 2, Hyderabad 500 034, India
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Grewal DS, Merlau DJ, Giri P, Munk MR, Fawzi AA, Jampol LM, Tanna AP. Peripapillary retinal splitting visualized on OCT in glaucoma and glaucoma suspect patients. PLoS One 2017; 12:e0182816. [PMID: 28832670 PMCID: PMC5568282 DOI: 10.1371/journal.pone.0182816] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Accepted: 07/25/2017] [Indexed: 11/18/2022] Open
Abstract
Purpose To identify the risk factors for development of peripapillary retinal splitting (schisis) in patients with glaucoma or suspicion of glaucoma Setting Glaucoma Clinic, Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, IL Methods In this institutional cross-sectional study, 495 patients (990 eyes) who had undergone spectral-domain optical coherence tomography (OCT Spectralis HRA-OCT, Heidelberg Engineering) optic nerve head (ONH) imaging and did not have identifiable optic nerve pits, pseudopits or coloboma were included. OCT scans were reviewed by two observers. Main outcome measures Presence of peripapillary retinal splitting identified on OCT raster scans. Results Eleven of 990 glaucoma and glaucoma suspect eyes (1.1%) of 7 patients (2 females, 5 males, mean age 64.5 ± 9.2 years) had peripapillary retinal splitting. Two of these 11 eyes had extension of the splitting into the macula but none to the fovea. Of these 11 patients, 2 (28.6%) were glaucoma suspects, 3 (42.9%) had primary open-angle glaucoma, 1 (14.3%) had chronic angle-closure glaucoma and 1 (14.3%) had pigmentary glaucoma. 7/11 (63.6%) eyes had vitreous traction to the disc visualized on OCT and 6/11 eyes (54.5%) had beta-zone peripapillary atrophy. Conclusions We observed peripapillary retinal splitting in 1.1% of a series of 990 glaucoma and glaucoma-suspect eyes. Evidence of adherent vitreous with traction and peripapillary atrophy was found in a majority of the involved eyes. A comparison to an age and axial length matched cohort is required to determine if this is a condition that is associated with glaucoma.
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Affiliation(s)
- Dilraj S. Grewal
- Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America
| | - Daniel J. Merlau
- Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America
| | - Pushpanjali Giri
- Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America
| | - Marion R. Munk
- Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America
| | - Amani A. Fawzi
- Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America
| | - Lee M. Jampol
- Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America
| | - Angelo P. Tanna
- Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America
- * E-mail:
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Avci R, Kapran Z, Ozdek Ş, Teke MY, Oz O, Guven D, Yilmaz S, Kaderli B, Durukan AH, Sobaci G, Unver YB, Akduman L, Kaynak S, Dogan I, Inan UU. Multicenter study of pars plana vitrectomy for optic disc pit maculopathy: MACPIT study. Eye (Lond) 2017; 31:1266-1273. [PMID: 28731058 DOI: 10.1038/eye.2017.142] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 06/19/2017] [Indexed: 11/09/2022] Open
Abstract
PurposeTo evaluate surgical intervention with pars plana vitrectomy (PPV) for correction of optic disc pit maculopathy (ODP-M).Patients and methodsRetrospective chart review from 13 centres of 51 eyes of 50 patients with ODP-M who underwent PPV between 2002-2014. Anatomic and final best-corrected visual acuity (BCVA) outcomes were evaluated for all cases with different adjuvant techniques.ResultsThere were 23 males and 27 females with median age 25.5 (6-68) years. Preoperative median foveal thickness was 694.5 (331-1384) μm and improved to 252.5 (153-1405) μm. Median BCVA improved from 20/200 (20/20000 to 20/40) to 20/40 (20/2000 to 20/20) with 20/40 or better in 31 eyes. Complete retinal reattachment was achieved in 44 eyes (86.3%) at 7.1 (5.9) months. The good surgical outcomes were achieved in different adjuvant groups. Median follow-up was 24 (6 to 120) months.ConclusionsThese results confirm the long-term effectiveness of PPV for ODP-M. Prospective studies are needed to determine the effectiveness of any adjuvant technique in improving the success of PPV for ODP-M.
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Affiliation(s)
- R Avci
- Department of Ophthalmology, Retina Eye Hospital, Bursa, Turkey
| | - Z Kapran
- Department of Ophthalmology, Maltepe University Medical School, Istanbul, Turkey
| | - Ş Ozdek
- Department of Ophthalmology, Gazi University Medical School, Ankara, Turkey
| | - M Y Teke
- Department of Ophthalmology, Ulucanlar Eye Education and Research Hospital, Ankara, Turkey
| | - O Oz
- Department of Ophthalmology, Adana Retina Eye Center, Adana, Turkey
| | - D Guven
- Department of Ophthalmology, Sisli Etfal Education and Research Hospital, Istanbul, Turkey
| | - S Yilmaz
- Department of Ophthalmology, Retina Eye Hospital, Bursa, Turkey
| | - B Kaderli
- Department of Ophthalmology, Uludag University Medical School, Bursa, Turkey
| | - A H Durukan
- Department of Ophthalmology, Gulhane Military Medical Academy, Ankara, Turkey
| | - G Sobaci
- Private Practice, Ankara, Turkey
| | - Y B Unver
- Department of Ophthalmology, International Kolan Hospital, Istanbul, Turkey
| | - L Akduman
- Department of Ophthalmology, Saint Louis University Medical School, Missouri, USA
| | - S Kaynak
- Department of Ophthalmology, Dokuz Eylul University Medical School, Izmir, Turkey
| | - I Dogan
- Department of Biostatistics, Kocatepe University Medical School, Afyonkarahisar, Turkey
| | - U U Inan
- Department of Ophthalmology, Kocatepe University Medical School, Afyonkarahisar, Turkey
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Papilloschisis: A Case Report. J Glaucoma 2017; 26:e217-e221. [PMID: 28671921 DOI: 10.1097/ijg.0000000000000706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
We report a case of papilloschisis, where the schisis is noted within the optic nerve tissue with no associated disc pit. This has not been reported in the literature to the best of our knowledge.
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75
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de Oliveira PRC, Berger AR, Chow DR. Use of Evicel Fibrin Sealant in Optic Disc Pit-Associated Macular Detachment. Ophthalmic Surg Lasers Imaging Retina 2017; 48:358-363. [PMID: 28419404 DOI: 10.3928/23258160-20170329-13] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 02/21/2017] [Indexed: 11/20/2022]
Abstract
Optic disc pit is a rare congenital anomaly of the optic nerve. Retinal detachment is a common complication with poor outcomes. Many surgical alternatives have been described for the treatment of this condition, producing variable results. Herein, the authors describe four cases of optic disc pit-associated macular detachment managed with pars plana vitrectomy, fluid-air exchange, drainage of subretinal fluid through the optic disc pit, temporal peripapillary laser, and application of Evicel fibrin sealant (human) (Ethicon, Bridgewater, NJ) over the optic disc head. Case 1 showed stable visual acuity and improvement of subretinal fluid. Cases 2 and 3 showed visual acuity and subretinal fluid improvements. At the 1-week follow-up visit, Case 4 showed almost total subretinal fluid absorption. The sealant invariably disappeared between 1 and 2 weeks and was tolerated by all patients. This case series suggests that Evicel fibrin sealant may be considered as an adjunctive option in the surgical treatment of optic disc pit-associated maculopathy. [Ophthalmic Surg Lasers Imaging Retina. 2017;48:358-363.].
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Ozdek S, Ozdemir HB. A NEW TECHNIQUE WITH AUTOLOGOUS FIBRIN FOR THE TREATMENT OF PERSISTENT OPTIC PIT MACULOPATHY. Retin Cases Brief Rep 2017; 11:75-78. [PMID: 26982208 DOI: 10.1097/icb.0000000000000293] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
PURPOSE To report the use of autologous fibrin for the treatment of persistent optic pit maculopathy. METHODS The authors report two patients with an optic pit-related serous macular detachment, which persisted after vitrectomy and internal limiting membrane peeling. Autologous fibrin was prepared from the patients' whole blood and injected over the optic disk pit area to seal the pit/coloboma area followed by fluid-air-gas exchange. RESULTS Retina stayed attached starting from the first postoperative visit till the last visit at 27 (Case 1) and 14 (Case 2) months after surgery. CONCLUSION The use of autologous fibrin for the treatment of optic disk pit-related serous macular detachment seems a worthy contribution to the treatment of persistent cases.
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Affiliation(s)
- Sengul Ozdek
- Department of Ophthalmology, School of Medicine, Gazi University
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77
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Wehrmann K, Stumpfe S, Pettenkofer M, Feucht N, Lohmann C, Maier M. [Maculopathy with optic nerve pits : Morphological criteria in SD-OCT]. Ophthalmologe 2017; 115:216-221. [PMID: 28405756 DOI: 10.1007/s00347-017-0490-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Optic pit is a congenital anomaly with malformation similar to coloboma of the optic disc. The cause of optic pit maculopathy is controversial. We used high resolution OCT to investigate changes in the vitreoretinal and vitreopapillary transition within optic pit eyes. METHODS The vitreoretinal and vitreo-papillary transition of 12 eyes was accurately analyzed using SD-OCT. We registered the following criteria: liquefaction of prepapillary vitreous, papillary vitreous traction, discontinuity within the hyaloid cortex and communication spaces between pit and retinal edema. RESULTS Communication gaps between pit and retinal edema were identified in 8 eyes. 4 eyes had a papillary vitreous traction. 4 showed a discontinuity in the hyaloid cortex. 2 of the 12 patients showed no maculopathy in SD-OCT. Those patients had an adjacent papillary vitreous without prepapillary liquefaction. However all eyes showed vitreous liquefaction at some stage premacullary or prepapillary. CONCLUSION Yet the cause of optic pit maculopathy is not clearly understood. High resolution OCT imaging provides a very detailed assessment of the vitreoretinal transition prepapillary and premacullary, however with limited penetration depth and analyzation of deeper lying structures. Our observations suggest that prepapillary liquefaction and pressure gradients within cerebrospinal and intraokular pressure could be key factors.
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Affiliation(s)
- K Wehrmann
- Augenklinik, Klinikum rechts der Isar, TU München, Ismaningerstrasse 22, 81675, München, Deutschland.
| | - S Stumpfe
- Augenklinik, Klinikum rechts der Isar, TU München, Ismaningerstrasse 22, 81675, München, Deutschland
| | - M Pettenkofer
- Augenklinik, Klinikum rechts der Isar, TU München, Ismaningerstrasse 22, 81675, München, Deutschland
| | - N Feucht
- Augenklinik, Klinikum rechts der Isar, TU München, Ismaningerstrasse 22, 81675, München, Deutschland
| | - C Lohmann
- Augenklinik, Klinikum rechts der Isar, TU München, Ismaningerstrasse 22, 81675, München, Deutschland
| | - M Maier
- Augenklinik, Klinikum rechts der Isar, TU München, Ismaningerstrasse 22, 81675, München, Deutschland
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D'Souza P, Babu U, Narendran V. Autologous Free Internal Limiting Membrane Flap for Optic Nerve Head Pit With Maculopathy. Ophthalmic Surg Lasers Imaging Retina 2017; 48:350-353. [DOI: 10.3928/23258160-20170329-11] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Accepted: 12/12/2016] [Indexed: 11/20/2022]
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79
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Shah PK, Karandikar SS, Narendran V. Scleral Autograft for Optic Nerve Head Pit Associated Chronic Maculopathy. Ophthalmic Surg Lasers Imaging Retina 2017; 48:251-254. [DOI: 10.3928/23258160-20170301-09] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Accepted: 01/12/2017] [Indexed: 11/20/2022]
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Akça Bayar S, Sarıgül Sezenöz A, Yaman Pınarcı E, Yılmaz G. Spontaneous Regression of Optic Disc Pit Maculopathy in a Six-Year-Old Child. Turk J Ophthalmol 2017; 47:56-58. [PMID: 28182177 PMCID: PMC5282544 DOI: 10.4274/tjo.57614] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2015] [Accepted: 03/06/2015] [Indexed: 12/01/2022] Open
Abstract
A 6-year-old boy with a complaint of blurred vision for two months was referred to our clinic. His visual acuity was 20/32 in the right eye and 20/20 in the left eye. Optical coherence tomography (OCT) revealed optic disc pit maculopathy in the right eye. The patient was followed for 6 months without any treatment. At the end of the 6-month period, the patient’s visual acuity was 20/20 in both eyes. The OCT imaging showed spontaneous regression of the optic disc pit maculopathy. In this case report, it is concluded that in children, spontaneous regression of the optic pit maculopathy with full recovery of visual acuity is possible. The development of optic pit maculopathy in childhood is rare and there are not enough studies on the treatment methods. Therefore, our case report may be helpful in the management of similar cases of pediatric optic disc maculopathy.
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Affiliation(s)
- Sezin Akça Bayar
- Başkent University Faculty of Medicine, Department of Ophthalmology, Ankara, Turkey
| | | | - Eylem Yaman Pınarcı
- Başkent University Faculty of Medicine, Department of Ophthalmology, İstanbul, Turkey
| | - Gürsel Yılmaz
- Başkent University Faculty of Medicine, Department of Ophthalmology, Ankara, Turkey
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Kiang L, Johnson MW. Formation of an Intraretinal Fluid Barrier in Cavitary Optic Disc Maculopathy. Am J Ophthalmol 2017; 173:34-44. [PMID: 27697474 DOI: 10.1016/j.ajo.2016.09.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Revised: 09/21/2016] [Accepted: 09/21/2016] [Indexed: 11/18/2022]
Abstract
PURPOSE Cavitary optic disc maculopathy develops when fluctuating pressure gradients along anomalous communications in the optic nerve head induce migration of fluid into the adjacent retinal tissue. We sought to determine whether carefully titrated laser photocoagulation combined with vitrectomy and gas tamponade can safely create an effective intraretinal barrier to fluid egress from the optic disc cavitation. DESIGN Retrospective interventional case series. METHODS We retrospectively evaluated medical records and imaging studies of 22 consecutive patients with cavitary disc maculopathy evaluated by a single surgeon between 1991 and 2014. Patients requiring surgery underwent carefully titrated juxtapapillary laser photocoagulation followed immediately by vitrectomy and gas tamponade. Main outcome measures were change in visual acuity, macular fluid resolution, and recurrence of maculopathy. RESULTS Eleven patients (11 eyes) had undergone vitreous surgery and were included in the study. No preoperative evidence for vitreous traction on the optic disc or macula was seen in any eye. Nine patients underwent a single surgery and 2 patients required additional procedures to resolve the macular fluid. Mean length of follow-up after the last surgery was 48.2 months (range, 4-143 months). All 11 patients (100%) had complete resolution of macular fluid, with an average time to resolution of 8.5 months (range, 1-18 months). Only 1 of 11 patients (9%) had recurrence of macular fluid (14 months postoperatively). The average preoperative visual acuity of 20/125 (logMAR 0.81, standard deviation [SD] = 0.36) improved by nearly 4 lines to an average final visual acuity of 20/57 (logMAR 0.45, SD = 0.37) (P = .0072). A possible laser-induced central scotoma was suspected in only 1 patient who had undergone extensive prior laser treatments. CONCLUSIONS An effective intraretinal barrier to fluid migration from cavitary optic disc anomalies can be safely achieved in most patients with carefully titrated juxtapapillary laser photocoagulation combined with vitrectomy and gas tamponade. Once achieved, the barrier facilitates resolution of macular fluid and long-term avoidance of recurrent maculopathy.
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Affiliation(s)
- Lee Kiang
- W.K. Kellogg Eye Center, Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan
| | - Mark W Johnson
- W.K. Kellogg Eye Center, Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan.
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Affiliation(s)
| | - Mahmoud Leila
- Retina-Vitreous Service, Ratan Jyoti Netralaya, Gwalior, India
- Retina Department, Research Institute of Ophthalmology, Cairo, Egypt
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83
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Optic Disk Pit with Sudden Central Visual Field Scotoma. Case Rep Ophthalmol Med 2016; 2016:1423481. [PMID: 27872777 PMCID: PMC5107830 DOI: 10.1155/2016/1423481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Revised: 09/01/2016] [Accepted: 09/08/2016] [Indexed: 11/17/2022] Open
Abstract
Purpose. To describe a case of optic disk pit (ODP) with sudden central visual field scotoma. Methods. A 49-year-old woman presented, reporting sudden painless central visual field loss 3 months prior to presentation. Neuroophthalmologic, systematic, and laboratory evaluation and full imaging processes were performed. Results. Fundoscopy and color photography demonstrated an optic disk pit inferotemporally. Perimetry identified central visual field horizontal scotoma. OCT revealed absence of serous retinal detachment, but disclosed inner retina thinning corresponding to the area of the visual field loss. Fluorescein angiography demonstrated delay in the cilioretinal arteries and also disclosed a relative delay in the perfusion of an arterial branch off the inferior retinal arcade. Clinical and laboratory evaluations were negative for any related pathology. Conclusion. Sudden central visual field scotoma in patients with ODP may be associated with delayed vascular filling of CRA and retinal arterioles within the optic disc anomaly region.
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84
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Dhingra N, Manoharan R, Gill S, Nagar M. Peripapillary schisis in open-angle glaucoma. Eye (Lond) 2016; 31:499-502. [PMID: 27834967 DOI: 10.1038/eye.2016.235] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 09/22/2016] [Indexed: 11/09/2022] Open
Abstract
PurposeTo report clinical features, topographic findings and outcome of 10 eyes with peripapillary schisis in open-angle glaucoma.Patients and methodsA retrospective review of patients with open-angle glaucoma who were noted to have peripapillary schisis on optical coherence tomography (OCT) were included. Serial peripapillary and macula infrared and OCT images, visual acuity, visual fields, and schisis appearance were reviewed.ResultsTen eyes of nine patients with open-angle glaucoma were detected to have the presence of peripapillary schisis. Nerve fibre layer schisis was detected in all eyes and one eye had an associated macular schisis. None of the eyes had an acquired pit of the optic nerve or pathological myopia. The mean intraocular pressures at detection was 18.3±4.3 mm Hg and the schisis resolved in four eyes after a mean follow-up of 21.2±8.8 months. Visual field worsening was noted in 4 of the 10 eyes and the resolution of schisis resulted in significant reduction in the retinal nerve fibre layer (RNFL) thickness.ConclusionsPeripapillary schisis detected during the normal course of open-angle glaucoma can resolve spontaneously and rarely involves the macula. Its resolution leads to reduction in RNFL thickness; therefore, caution is advised while interpreting serial scans.
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Affiliation(s)
- N Dhingra
- Pinderfields Hospital, Mid Yorkshire NHS Trust, Wakefield, UK
| | - R Manoharan
- Pinderfields Hospital, Mid Yorkshire NHS Trust, Wakefield, UK
| | - S Gill
- Pinderfields Hospital, Mid Yorkshire NHS Trust, Wakefield, UK
| | - M Nagar
- Pinderfields Hospital, Mid Yorkshire NHS Trust, Wakefield, UK
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A Rare Case of Symptomatic Double Optic Disc Pit without Maculopathy. Case Rep Ophthalmol Med 2016; 2016:2560568. [PMID: 27648324 PMCID: PMC5018347 DOI: 10.1155/2016/2560568] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Accepted: 07/14/2016] [Indexed: 11/18/2022] Open
Abstract
Optic disc pits are an uncommon congenital abnormality. Patients remain asymptomatic unless they develop maculopathy. We present a rare case of a double optic disc pit of which only three others have been reported worldwide. A 51-year-old gentleman presented with blurred vision. Fundoscopy revealed a right double optic disc pit. Though he was symptomatic there was no evidence of maculopathy. OCT of macula and disc was otherwise unremarkable. Visual field demonstrated a paracentral defect. Although optic disc pits are rare they are still an important clinical entity. Prompt identification and treatment of complications are required to prevent a poor visual prognosis.
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86
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MACULAR DETACHMENT ASSOCIATED WITH ANOMALOUS OPTIC NERVES AND DURAL ECTASIA IN 49, XXXXY SYNDROME. Retin Cases Brief Rep 2016; 12:39-41. [PMID: 27617393 DOI: 10.1097/icb.0000000000000409] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To present a case of a patient with XXXXY syndrome, anomalous optic nerves, and dural ectasia in conjunction with macular detachment. METHODS Case report. RESULTS A 3-year-old boy with XXXXY chromosomal abnormality presented with bilateral maculopathy. On evaluation, he was found to have anomalous optic disks with serous detachment of the left eye. Magnetic resonance imaging of the brain revealed bilateral optic nerve dural ectasia without evidence of elevated intracranial pressure. CONCLUSION XXXXY syndrome, like the related condition of Klinefelter syndrome, can manifest with ocular abnormalities. In the present case, the dural ectasia may have facilitated access of cerebrospinal fluid through anomalous optic nerves, resulting in neurosensory detachment.
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87
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The results of 25-gauge vitreoretinal surgery for optic disc pit-associated maculopathy: a report of three cases and mini-review of the literature. Int Ophthalmol 2016; 37:1057-1063. [PMID: 27614461 DOI: 10.1007/s10792-016-0336-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Accepted: 09/02/2016] [Indexed: 10/21/2022]
Abstract
PURPOSE We report the outcomes of three consecutive patients with optic disc pit-associated maculopathy who were treated with 25-gauge pars plana vitrectomy, internal limiting membrane (ILM) peeling, fluid-air exchange, barrage endolaser, and sulfur hexafluoride (SF6) gas tamponade. CASE REPORT Patients with optic disc pit-associated maculopathy were treated with 25-gauge pars plana vitrectomy followed by ILM peeling, fluid-air exchange, barrage endolaser, and gas tamponade with 20 % SF6. All patients were asked to maintain a facedown position for 3 days postoperatively. This technique resulted in complete retinal reattachment after 25-gauge vitrectomy, ILM peeling, fluid-air exchange, barrage endolaser, and 20 % SF6 gas injection. The best-corrected visual acuity (BCVA) improved in all three patients and successful anatomical results were achieved. There wasn't any macular detachment in all cases at 20th week follow-up. CONCLUSIONS Our outcomes suggest that 25-gauge vitrectomy with ILM peeling, fluid-air exchange, barrage endolaser, and SF6 gas tamponade appears to be an effective treatment option for optic disc pit-associated maculopathy.
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88
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Abstract
PURPOSE To evaluate the long-term outcomes of radial optic neurotomy (RON) in patients with optic disk pit maculopathy and to compare the functional and anatomical outcomes of pars plana vitrectomy (PPV) with temporal side single RON versus PPV without RON. METHODS This retrospective study included 15 eyes of 15 consecutive patients who had surgery for optic disk pit maculopathy. Patients were followed for 12 to 115 months after surgery. Anatomical and functional results were evaluated with optical coherence tomography, MP-1 microperimetry in the central 20°, and measurement of best-corrected visual acuity. Descriptive statistical methods, Friedman chi-square test, post hoc Dunn test, Mann-Whitney test, Wilcoxon signed-rank test, and Fisher's exact test were used to determine the best-corrected visual acuity and MP-1 microperimetry differences between time points and to compare the results between the two treatment groups. RESULTS Two male and 5 female patients with a mean age 23.3 ± 8.7 (±standard error) years at presentation had PPV and silicone oil or gas tamponade with RON. Best-corrected visual acuity did not deteriorate after the operation in any of the eyes, and improved in 6 (86%) eyes (3 ± 2 lines). After surgery, complete resolution of fluid in the central macula was observed in 6 (86%) eyes. Five male and 3 female patients with a mean age 28.2 ± 8.2 years at presentation had PPV, posterior vitreous detachment, with or without juxtapapillary laser treatment, and silicone oil or gas tamponade. Best-corrected visual acuity did not deteriorate after the operation in any of the eyes, and improved in 5 (62.5%) eyes (2 ± 0.7 lines). After surgery, fluid in the central macula resolved completely in 4 (50%) eyes. CONCLUSION Pars plana vitrectomy with temporal side, single RON seems to be an effective method of managing optic disk pit maculopathy. The anatomical and functional improvements, without additional treatment or complication during the follow-up period, indicate that RON might be an alternative treatment approach to PPV alone for optic disk pit maculopathy.
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89
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Chatziralli I, Theodossiadis P, Theodossiadis G. Current management of optic disc pit. EXPERT REVIEW OF OPHTHALMOLOGY 2016. [DOI: 10.1080/17469899.2016.1224654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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90
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[Optic disc pit-associated maculopathy and iris-retinochoroidal-coloboma - a rare combination]. Ophthalmologe 2016; 114:646-649. [PMID: 27514522 DOI: 10.1007/s00347-016-0340-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Kranenburg's syndrome is defined as central serous detachment associated with an optic disc pit. We report the interesting and very seldom combination of Kranenburg's syndrome and iris-retinochoroidal-coloboma. Reattachment was achieved after vitrectomy, peeling of epiretinal membranes, laser coagulation adjacent and temporal to the optic disc and gas endotamponade. Coincidence of this syndrome with an iris-retinochoroidal-coloboma is extremely rare. Both coloboma and optic disc pit are based on closure defects during week 6 of embryogenesis.
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91
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Peripapillary Retinoschisis in Glaucoma Patients. J Ophthalmol 2016; 2016:1612720. [PMID: 27069674 PMCID: PMC4812388 DOI: 10.1155/2016/1612720] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Revised: 02/16/2016] [Accepted: 02/21/2016] [Indexed: 11/18/2022] Open
Abstract
Purpose. To investigate peripapillary retinoschisis and its effect on retinal nerve fiber layer (RNFL) thickness measurements by using spectral-domain optical coherence tomography (SD-OCT) in glaucomatous eyes. Methods. Circumpapillary RNFL (cpRNFL) B-scan images of 940 glaucoma patients (Group 1) and 801 glaucoma-suspect patients (Group 2) obtained by SD-OCT were reviewed. The structural and clinical characteristics of the retinoschisis were investigated. The RNFL thickness measurements taken at the time of retinoschisis diagnosis and at the follow-up visits were also compared. Results. Twenty-nine retinoschisis areas were found in 26 of the 940 glaucoma patients (3.1%) in Group 1 and seven areas were found in 801 patients (0.87%) in Group 2. In glaucomatous eyes, the retinoschisis was attached to the optic disc and overlapped with the RNFL defect. At the time of retinoschisis, the RNFL thickness was statistically greater in the inferior temporal quadrant when compared with the follow-up scans (p < 0.001). No macular involvement or retinal detachment was observed. Conclusion. The present study investigated 33 peripapillary retinoschisis patients. Increase in RNFL thickness measurements was observed at the time of retinoschisis. It is important to examine the cpRNFL B-scan images of glaucoma patients so that the RNFL thickness is not overestimated.
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92
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Serous Macular Detachment Secondary to Optic Pit: Surgical Treatment and Long Time Results. Case Rep Ophthalmol Med 2016; 2016:4567840. [PMID: 26881159 PMCID: PMC4736323 DOI: 10.1155/2016/4567840] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Revised: 12/06/2015] [Accepted: 12/13/2015] [Indexed: 11/18/2022] Open
Abstract
32-year-old Turkish male patient presented with an optic disk pit and serous macular detachment in the left eye. Spectral domain optical coherence tomography revealed serous macular detachment and retinoschisis. After vitrectomy the retina gradually flattened and vision was gradually improved. We aimed to report a case of serous macula detachment secondary to optic pit and long term result of surgical treatment.
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93
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Mishra A, Aggarwal S, Bhargava N, Baranwal VK. Unusual coexistence of bilateral optic disc pits with unilateral macular hole. Med J Armed Forces India 2016; 71:S514-6. [PMID: 26858486 DOI: 10.1016/j.mjafi.2014.12.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Accepted: 12/19/2014] [Indexed: 10/24/2022] Open
Affiliation(s)
- Avinash Mishra
- Classified Specialist (Ophthalmology), Military Hospital, Ahemdabad, India
| | - Somesh Aggarwal
- Associate Professor, M & J Western Regional Institute of Ophthalmology, Ahemdabad, India
| | - Neeraj Bhargava
- Senior Advisor (Ophthalmology), Command Hospital (Southern Command), Pune, India
| | - V K Baranwal
- Senior Advisor (Ophthalmology), Command Hospital (Northern Command), Udhampur, India
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Gupta RR, Choudhry N. Spontaneous resolution of optic disc pit maculopathy after posterior vitreous detachment. Can J Ophthalmol 2016; 51:e24-7. [DOI: 10.1016/j.jcjo.2015.09.020] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Revised: 08/27/2015] [Accepted: 09/23/2015] [Indexed: 11/17/2022]
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Retinal complications associated with congenital optic disc anomalies determined by swept source optical coherence tomography. Taiwan J Ophthalmol 2016; 6:8-14. [PMID: 29018703 PMCID: PMC5602127 DOI: 10.1016/j.tjo.2015.05.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Accepted: 05/20/2015] [Indexed: 11/29/2022] Open
Abstract
Optical coherence tomography has evolved over the past 2 decades to be an important ancillary method to evaluate diseases of the anterior and posterior segments of the eye. The more recent development of swept-source optical coherence tomography (SS-OCT) with a wavelength-tunable laser centered at 1050 nm and deeper imaging depth of 2.6 mm has enabled clinicians to evaluate congenital optic disc anomalies including optic disc pits, optic disc colobomas, and morning glory syndrome in more detail. The SS-OCT findings of the posterior precortical vitreous pocket, Cloquet's canal, lamina cribrosa that is torn from the peripapillary sclera, and the retrobulbar subarachnoid space immediately posterior to the highly reflective tissue lining the bottom of the excavation are presented. In addition, abnormal communications between the vitreous cavity and the subretinal and subarachnoid spaces in eyes with congenital optic disc anomalies are also reviewed. The retinal complications associated with congenital optic disc anomalies are treated by vitreous surgery, silicone oil tamponade, and peripapillary laser photocoagulation or scleral buckling. However, the surgical outcomes are limited and not entirely satisfactory. Analyses by SS-OCT of congenital optic disc anomalies should make the treatment correspond better with the pathological findings.
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96
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97
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Hsu CL, Layton CJ. Familial Disorders of the Optic Disc: Presentation of a Mother and Daughter and Review of the Literature. Case Rep Ophthalmol 2015; 6:251-9. [PMID: 26327911 PMCID: PMC4553917 DOI: 10.1159/000437381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Optic disc pit and optic nerve coloboma are examples of congenital optic disc abnormalities. Although optic nerve coloboma can be inherited in an autosomal dominant fashion, no conclusive link has been found in the case of optic disc pit as an autosomal dominant disease. We describe two cases: a daughter with an optic disc pit complicated by maculopathy and her mother with a congenitally abnormal optic disc complicated by peripapillary choroidal neovascularisation.
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Affiliation(s)
- Chia Lee Hsu
- Ophthalmology Unit, Greenslopes Private Hospital, Brisbane, Qld., Australia
| | - Christopher J Layton
- Ophthalmology Unit, Greenslopes Private Hospital, Brisbane, Qld., Australia ; Gallipoli Medical Research Institute, Greenslopes Private Hospital, Brisbane, Qld., Australia ; The University of Queensland School of Medicine, Brisbane, Qld., Australia
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Daruich A, Matet A, Dirani A, Bousquet E, Zhao M, Farman N, Jaisser F, Behar-Cohen F. Central serous chorioretinopathy: Recent findings and new physiopathology hypothesis. Prog Retin Eye Res 2015; 48:82-118. [DOI: 10.1016/j.preteyeres.2015.05.003] [Citation(s) in RCA: 425] [Impact Index Per Article: 47.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Revised: 05/10/2015] [Accepted: 05/14/2015] [Indexed: 02/08/2023]
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Abouammoh MA, Alsulaiman SM, Gupta VS, Mousa A, Hirakata A, Berrocal MH, Chenworth M, Chhablani J, Oshima Y, AlZamil WM, Casella AM, Papa-Oliva G, Banker AS, Arevalo JF. Pars plana vitrectomy with juxtapapillary laser photocoagulation versus vitrectomy without juxtapapillary laser photocoagulation for the treatment of optic disc pit maculopathy: the results of the KKESH International Collaborative Retina Study Group. Br J Ophthalmol 2015; 100:478-83. [DOI: 10.1136/bjophthalmol-2015-307128] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Accepted: 08/01/2015] [Indexed: 11/04/2022]
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100
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Moisseiev E, Moisseiev J, Loewenstein A. Optic disc pit maculopathy: when and how to treat? A review of the pathogenesis and treatment options. Int J Retina Vitreous 2015; 1:13. [PMID: 27847606 PMCID: PMC5088488 DOI: 10.1186/s40942-015-0013-8] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Accepted: 07/30/2015] [Indexed: 11/10/2022] Open
Abstract
Optic disc pit (ODP) is a rare congenital anomaly of the optic disc, which can be complicated by a maculopathy associated with progressive visual loss. Optic disc pits are usually unilateral and sporadic in occurrence, and the development of maculopathy is unpredictable with no known triggers. Optic disc pit maculopathy (ODP-M) is characterized by intraretinal and subretinal fluid at the macula, causing visual deterioration. The source of this fluid is still unclear, and several competing theories have suggested it may be vitreous fluid, cerebrospinal fluid, leakage from blood vessels at the base of the pit or leakage from the choroid. The mechanism of pathogenesis of ODP-M has not been fully elucidated, but vitreous liquefaction and traction and pressure gradients within the eye have been implicated to be involved. There are no clear guidelines on the management of patients with ODP-M, and numerous techniques have been described, including laser photocoagulation, intravitreal gas injection, macular buckling and pars plana vitrectomy with many different modifications. The majority of reports describe small series, and as there are no comparative studies there is no consensus regarding the optimal treatment for ODP-M. This review discusses the literature on the possible sources of fluid and mechanisms of pathogenesis in ODP-M, as well as the wide array of treatment modalities and their results. Based on these, a set of recommended key concepts for the timing and choice of treatment for these challenging are presented.
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Affiliation(s)
- Elad Moisseiev
- grid.413449.f0000000105186922Department of Ophthalmology, Tel Aviv Sourasky Medical Center, 6 Weitzman st., Tel Aviv, 64239 Israel ; grid.12136.370000000419370546Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel ; grid.413079.80000000097528549Department of Ophthalmology and Visual Science, UC Davis Medical Center, Sacramento, CA USA
| | - Joseph Moisseiev
- grid.413795.d0000000121072845Department of Ophthalmology, Sheba Medical Center, Ramat Gan, Israel ; grid.12136.370000000419370546Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Anat Loewenstein
- grid.413449.f0000000105186922Department of Ophthalmology, Tel Aviv Sourasky Medical Center, 6 Weitzman st., Tel Aviv, 64239 Israel ; grid.12136.370000000419370546Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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