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

Luo, Lei; Li, T; Ding, Xiaoyan; Ma, Wei; Zhu, Xiaobo; Atik, Alp; Hu, Yin; Tang, Shibo

doi:10.1038/eye.2014.245

Cited by 39 publications

(43 citation statements)

References 22 publications

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“…This technique was used in small series, and resulted in visual improvement, although retinal reattachment was only achieved in about half of the cases [52, 53]. One small series of patients treated with a combination of intravitreal gas injection and laser photocoagulation temporal to the disc reported visual improvement and reduction in fluid in all eyes, and complete resolution of intraretinal and subretinal fluids in 75% of eyes [54]. These studies are summarized in Table 1.…”

Section: Reviewmentioning

confidence: 99%

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

2015

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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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Section: Reviewmentioning

confidence: 99%

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

2015

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“…However, persistence of subretinal fluid and controversy surrounding appropriate additional maneuvers (eg, induction of posterior vitreous detachment or internal limiting membrane peeling) means that there is still no standard treatment for ODP maculopathy. 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 The success rate after vitrectomy for ODP maculpathy is around 70–92.3%, and there is no consensus regarding the appropriate treatment in case of failure. 2 , 8 Time of complete resolution has been reported around six months in about 60% of patients, and in some cases resolution can be expected until month twelve after surgery.…”

Section: Discussionmentioning

confidence: 99%

“… 1 , 2 Maculopathy presents in 25–75% of patients with an ODP, and although spontaneous reattachment has been reported, most of the cases have a poor prognosis with gradual worsening of visual acuity. 1 , 2 , 3 , 4 …”

Section: Introductionmentioning

confidence: 99%

Micropulse laser for persistent optic disc pit maculopathy. A case report

Valdés-Lara

Crim

García-Aguirre

et al. 2018

American Journal of Ophthalmology Case Reports

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PurposeOptic disc pits (ODP) are rare and congenital anomalies of the optic disc, sometimes remaining asymptomatic. However, serous macular detachment or optic disc maculopathy is the most common complication, causing significant visual deterioration, without a current consensus about treatment. We describe a case of ODP maculopathy that was treated successfully with micropulse laser.ObservationsA patient with ODP maculopathy remained with macular serous detachment after nine months of follow up after pars plana vitrectomy. Subthreshold micropulse laser was used to treat macular serous detachment, achieving a significant improvement in central macular thickness after one session.Conclusions and importanceSubthreshold micropulse laser is designed to stimulate the retinal pigment epithelium without damage to the photoreceptors, resulting in absorption of subretinal and intraretinal fluid. Macular serous detachment in patients with ODP requires a prompt diagnosis and treatment to avoid damage to photoreceptors. Subthreshold micropulse laser is a potential treatment for eyes with ODP and macular serous detachment complication.

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“…Et al in 9 patients performing combined treatment as central posterior vitrectomy with removal of posterior hyaloid membrane, laser coagulation and gas tamponade of the vitreous cavity. [4,8,10].…”

Section: Discussionmentioning

confidence: 99%

A case of successful laser coagulation in pediatric ophthalmology: a patient with the optic disc pit complicated by serous neuroepithelial detachment

Shevchenko¹,

Consultative²

2016

Oftalmol Zh

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Optic disk pit has been considered as coloboma located, as a rule, near temporal part of the optic disc. Central serous retinal detachment develops in 50 % of patients. The purpose of the present study was to show practically the possibility to use laser coagulation as an entire method for treatment of optic disc pit complicated by serous neuroepithelial detachment in children. Material and Methods. A patient, 4 y/o, with Jensen's retinochoroiditis juxtapapillaris, optic disc pit and serous neuroepithelial detachment was followed up. The patient was performed 532 nm laser, optical coherent tomography, visiometry, biomicroscopy, ophthalmoscopy and immunology research. Results. Visual acuity increased from 0.08 to 0.5 after treatment. Neuroepithelial attachment was achieved with residual detachment up to 40 µm. Conclusions. This case demonstrates that laser coagulation of the retina can be used as a separate and minimally invasive method of treatment for patients with optic disk pits complicated by serous neuroepithelial detachment in pediatric ophthalmology.

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

Cited by 39 publications

References 22 publications

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

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

Micropulse laser for persistent optic disc pit maculopathy. A case report

A case of successful laser coagulation in pediatric ophthalmology: a patient with the optic disc pit complicated by serous neuroepithelial detachment

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