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.

/pdf/optic-disc-pit-maculopathy-when-and-how-to-treat-a-review-of-23omywgo7o.pdf

Optic disc pit maculopathy: when and how to treat? A review of the pathogenesis and treatment options

Optic disk pits and optic disk pit maculopathy: A review.

Topographic analyses of shape of eyes with pathologic myopia by high-resolution three-dimensional magnetic resonance imaging

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.

A new technique with autologous fibrin for the treatment of persistent optic pit maculopathy.

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.

Long-term outcomes of radial optic neurotomy for management of optic disk pit maculopathy.

To explore short‐term changes after left bundle branch pacing (LBBP) using echocardiography and computed tomography (CT), especially for postoperative ventricular septal perforation.

Occurrence of ventricular septal perforation in patients with permanent left bundle branch pacing followed up using echocardiographic and computed tomography images

Response to: ‘Comment on Gas tamponade combined with laser photocoagulation therapy for congenital optic disc pit maculopathy’

/pdf/response-to-comment-on-gas-tamponade-combined-with-laser-2x2ni9zx2z.pdf

Response to: 'Comment on Gas tamponade combined with laser photocoagulation therapy for congenital optic disc pit maculopathy'.

To study the characteristic morphology and quantitatively evaluate the eye shape in different types of myopic maculopathy. A total of 103 eyes from 65 patients with high myopic maculopathy were examined by spectral-domain optical coherence tomography (SD-OCT) and three-dimensional magnetic resonance imaging (3D MRI). The participants were classified into two groups, namely myopic traction maculopathy (MTM) eyes and non-MTM eyes, with SD-OCT imaging. Volume renderings and morphology analysis of the 3D MRI of the eyeball were obtained. Quantitative analysis was achieved in the calculation of vitreous volume and the three-dimensional diameters of the eyeball in three cardinal axes. The eye shape distribution and the diameters of the eyeball were compared between the two groups. Eye shape distribution, vitreous volume, and eyeball diameter were compared between MTM and non-MTM eyes. The MTM and non-MTM groups had a total of 68 and 35 eyes, respectively. A significant difference was found in the eye shape distribution (P 0.05) in either vitreous volume or other diameters between the two groups. Non-uniform globe expansion and staphyloma formation might play an important role in the pathogenesis of MTM.

/pdf/morphological-analysis-and-quantitative-evaluation-of-myopic-2aagbkfebi.pdf

Morphological analysis and quantitative evaluation of myopic maculopathy by three-dimensional magnetic resonance imaging.

Gas tamponade combined with laser photocoagulation therapy for congenital optic disc pit maculopathy

/pdf/gas-tamponade-combined-with-laser-photocoagulation-therapy-2disrrhxos.pdf

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Occurrence of ventricular septal perforation in patients with permanent left bundle branch pacing followed up using echocardiographic and computed tomography images

Response to: 'Comment on Gas tamponade combined with laser photocoagulation therapy for congenital optic disc pit maculopathy'.

Morphological analysis and quantitative evaluation of myopic maculopathy by three-dimensional magnetic resonance imaging.

Gas tamponade combined with laser photocoagulation therapy for congenital optic disc pit maculopathy