New insight into the pathology of macular detachment associated with an optic disc pit

Comparative findings in childhood-onset versus adult-onset optic disc pit maculopathy

PURPOSE

To compare the clinical characteristics of eyes with childhood-onset to those with adult-onset optic disc pit maculopathy.

METHODS

Twenty-seven eyes of 25 patients with optic disc pit maculopathy were reviewed. The clinical characteristics, clinical history including a history of blunt trauma, ophthalmoscopic evaluations and intraoperative findings in the childhood-onset (age <15 years, four eyes of four patients) cases were compared with those in the adult-onset (≥15 years, 23 eyes of 21 patients) cases of optic disc pit maculopathy. The strength of the vitreous adhesions was graded by what was required to create a posterior vitreous detachment (PVD); grade 1 = with vitreous cutter, grade 2 = by microhook or forceps and grade 3 = by forceps with removal of remnants of Cloquet's canal.

RESULTS

The incidence of visual impairments following blunt trauma was significantly higher in childhood-onset (three of four eyes) than that of adult-onset (0 of 23 eyes, p = 0.0014). Vitreous surgery with creation of a PVD was performed in the four childhood-onset eyes and 18 adult-onset eyes after an absence of a spontaneous resolution. The grade of the vitreous adhesions was significantly higher in childhood-onset than in adult-onset eyes (p = 0.0096).

CONCLUSIONS

An ocular trauma may provide an opportunity to detect optic disc pits. However, childhood-onset optic disc pit maculopathy was noted most commonly following blunt ocular trauma in eyes with a strong vitreous adhesion to the optic disc margin.