Photocoagulation of Optic Disc Pits

Kottow, Miguel

doi:10.1159/000309181

Cited by 12 publications

(6 citation statements)

References 3 publications

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“…In a study of 18 patients Abujamra et at8 treated 10 with photocoagulation and achieved full reattachment in only one case. Kapel et al9 reported on 14 patients with optic disc pit, eight of whom had an associated macular detachment and five were treated with argon laser, all unsuccessfully, and they concluded that no effective treatment was available for this serious complication.…”

Section: Discussionmentioning

confidence: 99%

Vitrectomy, argon laser, and gas tamponade for serous retinal detachment associated with an optic disc pit: a case report.

Snead

James

Jacobs

1991

British Journal of Ophthalmology

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We report the case of a 9-year-old boy with a right optic disc pit and associated serous retinal detachment of the macula. This was treated by vitrectomy, endolaser, and gas tamponade as a primary procedure, which resulted in complete resolution. We review the literature and conclude that further reports of the management of this uncommon condition are required so that firmer guidelines on treatment can be established.A 9-year-old Caucasian boy presented to the eye casualty department in July 1989 with a sixmonth history of decreased visual acuity. A year previously an optician had recorded unaided visual acuities of 6/6 right eye and 6/6 left eye. There was no relevant past ocular or medical history of note.On examination his unaided visual acuities were 6/6 left and 1/60 right eye. There was no improvement with refraction. The anterior segment appeared normal, he had a right relative afferent pupil defect, and funduscopy revealed a serous retinal detachment of the macula clearly linked to an optic disc pit in the right eye. The detached retina had undergone cystic retinal degeneration, and the underlying pigment epithelium was irregularly pigmented (Fig 1). The left fundus was normal. The patient thought that there had been a recent improvement in the vision of the right eye, and treatment was therefore deferred and serial observations carried out. After nine months no further improvement had occurred. Various methods of treatment (see 'Discussion') were considered, and, though laser photocoagulation alone has met with some success, in view of the patient's age this would University Hospital, Nottingham M P Snead N James P M Jacobs have required a general anaesthetic. Vitrectomy and laser photocoagulation followed by fluid/gas exchange seemed to offer the highest chance of success with a single procedure (and anaesthetic), and it was agreed to proceed with surgery.On 10 April 1990 the patient underwent right pars plana vitrectomy, endolaser treatment, and 40% SF6 exchange. A standard 20 g three-port pars plana vitrectomy was performed, and during surgery the vitreous was noted to be still attached. Argon endolaser was applied temporal to the disc in a confluent double line of burns to seal off the link between pit and detachment and extended superiorly and inferiorly into attached retina. This was applied after the vitrectomy and before fluid-gas exchange in order to minimise any laser induced damage to the papillomacular bundle. A power setting was used which was just sufficient to produce a soft white burn in an area of attached retina and then applied in the distribution described above. This produced minimal or no reaction in the pigment epithelium underlying the detached retina at the time of application. There was no evident communication between the detachment and the vitreous cavity, and no attempt was made to drain subretinal fluid. The posterior segment was filled with 40% SF6 in air.Postoperatively the posterior retina was attached, but there was a collection of subretinal fluid inferiorly....

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Section: Discussionmentioning

confidence: 99%

Vitrectomy, argon laser, and gas tamponade for serous retinal detachment associated with an optic disc pit: a case report.

Snead

James

Jacobs

1991

British Journal of Ophthalmology

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“…CF -counting finger. [14], Brockburst [15], Kottow [16], Theodossiadis [17], Annesly et al [18], Jack [24] and Lincoff et al [28]. Data of 6 eyes from Bonnet [19] had to be excluded, because visual acuity of the initial examinations was missing.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore surgical intervention using diathermy [11] or scleral folding [12] has been proposed. At present photocoagulation [13][14][15][16][17][18], pneumatic retinopexy [19,20] and vitrectomy [7,8,21,22] are recommended.…”

Section: Introductionmentioning

confidence: 99%

Vitrectomy for macular detachment associated with optic nerve pits

1996

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“…Since the first description of the disease by Wiethe in 1882 some open questions still persist regarding the origin of the fluid, the type of macular elevation (Lincoff et al 1988;Kranenburg 1960;Streiff 1944), the treatment modalities (Theodossiadis 1977(Theodossiadis , 1988Lincoff et al 1988;Wiethe 1882;Vogel & Wessing 1974;Brockhurst 1975;Kottow 1982;Annesley et al 1987;Alexander & Billson 1984;Cox et al 1988;Schatz & McDonald 1988) and especially the natural history of the disease. As it is known hitherto, the study of the natural history has been confined to the changes of visual acuity and alterations of the fovea.…”

Section: Discussionmentioning

confidence: 99%

Long‐term study of patients with congenital pit of the optic nerve and persistent macular detachment

Theodossiadis

Panopoulos

Kollia

et al. 1992

Acta Ophthalmologica

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During the period 1970-87 we evaluated the changes of the optic disc, peripapillary area, detached macula and visual acuity in 16 cases with congenital pit of the optic nerve and macular detachment. The study revealed in 9 of the 16 cases (56%) an increase of the dimension of the pit or changes in its color, findings which were directly related to the duration of the macular detachment. Chorioretinal scarring, pigment migration, or both, were also noted mainly at the temporal margin of optic disc. In 5/16 cases we found during the follow-up an extension of macular elevation. In altogether 10 out of 16 cases the retinal elevation covered the larger portion of the mid-periphery temporally. In 7/16 cases the final visual acuity remained unchanged, in 9/16 cases deteriorated. The difference, however, in the latter 9 cases between initial and final visual acuity was negligible. During the follow-up period deterioration of the visual fields was also noted.

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Photocoagulation of Optic Disc Pits

Cited by 12 publications

References 3 publications

Vitrectomy, argon laser, and gas tamponade for serous retinal detachment associated with an optic disc pit: a case report.

Vitrectomy, argon laser, and gas tamponade for serous retinal detachment associated with an optic disc pit: a case report.

Vitrectomy for macular detachment associated with optic nerve pits

Long‐term study of patients with congenital pit of the optic nerve and persistent macular detachment

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