Surgical outcomes in patients with optic disc pit maculopathy: does peeling the ILM lead to better outcomes?

Changes in Outcomes of Macular Optical Coherence Tomography Angiography Following Surgery for Optic Disc Pit Maculopathy

PURPOSE

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).

CONCLUSION

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.

Vitrectomy for macular retinoschisis associated with peripapillary intrachoroidal cavitations in a moderately myopic eye

Background

Peripapillary intrachoroidal cavitation (PICC), a cavernous change in the peripapillary choroid, may present with macular lesions. Here, we present a rare case of PICC with outer lamellar macular hole and macular retinoschisis.

Case presentation

A 69-year-old man presented with metamorphopsia in the left eye. Fundus examination revealed macular retinoschisis and PICCs. Pars plana vitrectomy with fovea sparing internal limiting membrane peeling (FSIP) was performed. Three weeks postoperatively, the patient developed rhegmatogenous retinal detachment and underwent a second vitrectomy. The macular retinoschisis resolved without macular hole formation and the patient’s visual acuity improved. There were no recurrent macular lesions over the three years of postoperative follow-up. Postoperative spectral-domain optical coherence tomography scan revealed a communication between the PICC and the vitreous cavity.

Conclusions

This case shed light on understanding development of PICC in non-highly myopic eyes and a rare complication of macular retinoschisis. Vitrectomy with FSIP may effectively resolve macular retinoschisis.