Long-Term Outcomes for Optic Disk Pit Maculopathy After Vitrectomy

Abstract

Vitrectomy for macular detachment due to optic disk pit has good long-term success and results in an improvement in visual acuity. However, adjuvant techniques such as internal limiting membrane peel and temporal endolaser may not improve outcomes, nor does there seem to be a difference between short- and long-acting gases. Patients should be made aware that it can take more than a year and multiple surgeries to achieve foveal reattachment and that increased baseline central retinal thickness is a poor prognostic sign.

Efficacy of Internal Limiting Membrane Flap Techniques with Vitrectomy for Macular Detachment Associated with an Optic Disc Pit

“…Our results suggest that laser treatment does not aid in anatomical success. This is in keeping with previous studies that have shown similar anatomical outcomes with PPV without juxtapapillary laser photocoagulation for ODP [13, 19-22]. …”

“…However, this method of treatment has largely fallen out of favour because the location of laser treatment over the maculopapular bundle can cause significant visual field defects [10, 11, 13]. Our results suggest that laser treatment does not aid in anatomical success.…”

“…Even though several successful treatments have been reported (Table 3), there are still no established guidelines for the optimal surgical technique or for the treatment of ODP associated with maculopathy [8, 10, 11, 13]. Similarly, there is little consensus regarding which combination of adjuvant procedures to PPV maximizes surgical success while minimizing side effects and possible complications [10-22].…”

“…In fact, vitreopapillary traction is thought to play the most critical role [3, 6, 23, 24]. Vitrectomy with induction of PVD to release vitreous traction over the macula and ODP plays a vital role in the treatment of this entity [3, 6, 13, 19, 20-23]. Hirakata et al [21] reported that for patients with ODP maculopathy, there was a reduction in retinal elevation bordering the optic disc and a decrease in retinal schisis postoperatively when PPV and induction of PVD without laser were performed.…”

“…Currently, the most widely accepted treatment for this condition is pars plana vitrectomy (PPV). The necessity of adjuvant surgical procedures such as temporal ODP endolaser photocoagulation [10-13], autologous platelet concentrate [14] and many others remains unclear. Nevertheless, interventions for the treatment of ODP maculopathy are valuable, as they may prevent significant visual loss in these patients.…”