Optical Coherence Tomography Study of Vitreoretinal Interface in Full Thickness Macular Hole Associated with Optic Disk Pit Maculopathy

Abstract

Previously unreported OCT findings such as vitreous traction at the edge of the macular hole and on the elevated macula were found. OCT provided evidence for vitreous participation in full thickness macular hole associated with optic disk pit maculopathy. OCT was also able to show that the full thickness macular hole and optic disk pit maculopathy were probably caused by similar vitreous tractional forces.

Vitrectomy for Optic Disk Pit With Macular Schisis and Outer Retinal Dehiscence

“…However, both tangential and anteroposterior traction are believed to facilitate the passage of fluid from the optic pit into the macular retina, 12,13,17,18 and the tangential traction cannot be completely eliminated without removing ILM. [11][12][13] Second, based on our and others' experience with vitrectomy for pits and other pathologies with a thickened macula and thinned-out neural tissue, we believe that the step most conducive to iatrogenic macular hole formation is the removal of posterior hyaloid, which is strongly adherent to the thinned-out retina.…”

“…9,14,19 Third, none of the eyes were observed to develop macular hole intraoperatively or in the immediate postoperative period, as is likely to occur if the iatrogenic trauma is the cause of macular hole, 9,19 although we were unable to confirm our subjective observations with intraoperative or postoperative OCT in gas-filled eyes. Finally, macular holes have been reported in the natural course of schisis secondary to optic pits 5,17,20,21 and are associated with poor visual prognosis. 21 Internal limiting membrane peeling with gas tamponade assured the closure of consequent macular holes and gave excellent visual outcomes with minor or no additional intervention.…”

Optic Disc Pit Maculopathy: The Value of Small-Gauge Vitrectomy, Peeling, Laser Treatment, and Gas Tamponade

“…They performed macular buckling procedure to relieve vitreomacular traction and obtained anatomic and functional success in 9 out of 9 eyes (20). The fact that longstanding OPM can result in a macular hole demonstrates that probably the same tractional force is active in both pathologies (8). In fact, patient 6 presented a macular hole in addition to OPM and had a history of 12 months.…”

Macular Buckling in Optic Disc Pit Maculopathy in Association with the Origin of Macular Elevation: 13-Year Mean Postoperative Results

“…In the cases where the VMT was present, it was extended between the optic disc and the macular area (papillomacular traction). Vitreomacular traction was present in 2 cases with lamellar macular hole and in the 1 case with full-thickness macular hole (13). There was a trend to statistically significant difference as to the percentage of VMT between the baseline and the last examination (p = 0.046), while there was no statistically significant difference in the other examinations.…”