Reversal of a glaucomatous optic disc pit

Kim, Bum Gi; Kim, Ko Eun; Weinreb, Robert N.; Oh, Won Hyuk

doi:10.1016/j.ajoc.2021.101143

Cited by 3 publications

(5 citation statements)

References 11 publications

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“…23,24 Thus, in contrast to the congenital ODPM, the primary treatment objective for an eye with glaucomatous ODPM would be to primarily prevent the intraocular pressure fluctuations. 10,12,25 In this study, we observed one eye in which maculopathy signs resolved completely following trabeculectomy surgery alone. The demographic, clinical, and OCT characteristics of congenital and acquired ODPM may serve as a guide when considering intervention in such cases, giving the current study clinical significance.…”

Section: Discussionmentioning

confidence: 67%

Congenital versus acquired optic disc pit maculopathy: An OCT based study

Prabhu,

Venkatesh,

Kathare

et al. 2023

European Journal of Ophthalmology

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Purpose The purpose of this study is to describe and compare the demographic, ocular, and imaging characteristics of a cohort of patients with congenital and acquired optic disc pit maculopathy (ODPM). Methods This retrospective case series included patients diagnosed with ODPM between June 2017 and April 2023. These patients’ baseline demographics, ocular characteristics, and optical coherence tomography (OCT) imaging characteristics and follow up changes were analyzed. Results A total of 14 eyes with ODPM were identified (9 congenital and 5 acquired). Eyes with congenital ODP developed maculopathy at a younger age, presented commonly with visual symptoms, and exhibited an obvious pit at the temporal foveal margin as well as a high cup: disc ratio ( p < 0.05). Primary open-angle glaucoma was identified in all five eyes with acquired ODPM. On OCT, eyes with acquired ODPM lacked the characteristic nerve fibre layer schisis, outer retinal layer hole, and foveal serous macular detachment ( p < 0.05) unlike congenital ODPM. At the final follow-up visit, two cases from the congenital ODPM group and one case from the acquired ODPM group displayed complete resolution of maculopathy. The two cases of congenital ODPM were treated with pars plana vitrectomy and laser barrage to the optic disc margin, while the solitary case of acquired ODPM was treated with trabeculectomy surgery alone. Conclusion Clinical examination and baseline OCT imaging reveal distinct differences between congenital and acquired ODPM eyes. These characteristics may help with accurate diagnosis and treatment planning for these two distinct clinical entities.

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Section: Discussionmentioning

confidence: 67%

Congenital versus acquired optic disc pit maculopathy: An OCT based study

Prabhu,

Venkatesh,

Kathare

et al. 2023

European Journal of Ophthalmology

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“…A known complication of an ODP is maculopathy. It has been reported that an optic disc pit can resolve after starting ocular hypotensive medicationand that ODP maculopathy may resolve spontaneous or after posterior vitreous detachment [1,2]. however, this case is the first to show a reversal of glaucomatous ODP associated maculopathy after topical ocular hypotensive medication, more specifically, a prostaglandin analog.…”

Section: Discussionmentioning

confidence: 68%

“…An optic disc pit (ODP) can be acquired as a result of localized glaucomatous damage [1]. A known complication of an ODP is maculopathy.…”

Section: Discussionmentioning

confidence: 99%

“…This is thought to occur especially in patients with glaucoma where lamina cribosa is altered as part of the glaucomatous optic nerve damage, which then can lead to a focal formation of the optic disc pit [6][7][8][9]. While this is not the most common presentation for patients with glaucoma, there had been studies [10] that found a higher prevalence of acquired optic disc pit in people with normaltension glaucoma, and successful reversal of those pits with IOP lowering drops [1,11,12]. In our case, we postulate that an increase in the uveoscleral outflow from bimatoprost may have altered the tissue remodeling through glial cell activation to facilitate the closure of optic disc pit as well as the resolution of the subretinal and intraretinal fluid.…”

Section: Discussionmentioning

confidence: 99%

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Treating Acquired Optic Disc Pit Maculopathy with an Ocular Hypotensive Agent

Shrier¹

2023

J Ocular Biol

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Purpose: To describe a case of glaucomatous optic disc pit maculopathy that resolved after bimatoprost treatment.Observations: A 63-year-old African American female with a history of type 2 diabetes mellitus presented to the clinic after 3 months of blurry vision in the right eye and was found to have an asymmetric cup-to-disc ratio, and right intraretinal and subretinal fluid without leakage on fluorescein angiography concerning for optic disc pit maculopathy. A trial of intravitreal anti-vascular endothelial growth factor (VEGF) injection failed to resolve the fluid. Optical coherence tomography of the ganglion cell complex showed thinning of the ganglion cell complex concerning for previously undiagnosed glaucoma, and the patient was started on bimatoprost. The previously noted fluid resolved, and the patient has been quiescent for 4 years on ocular hypotensive medication. Conclusion:In untreated or poorly controlled glaucoma, progressive cupping of the optic nerve head may lead to the development of an acquired optic disc pit, which can produce maculopathy. This maculopathy can improve under ocular hypotensive treatment.

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“…[1][2][3][4][5] Following ocular hypotensive treatment, Kim et al reported the reversal of a glaucomatous optic disc pit without maculopathy. 6 Maculopathy in an optic disc pit is usually accompanied by retinoschisis and/or serous macular detachment and retinal pigment epithelial changes. 7 Surgical intervention in the form of pars plana vitrectomy with internal limiting membrane peeling and gas endotamponade is frequently the treatment of choice for cases of maculopathy caused by an optic disc pit.…”

Section: Introductionmentioning

confidence: 99%

Successful resolution of serous macular detachment following glaucoma-filtering surgery alone for acquired optic disc pit maculopathy

Venkatesh,

Shroff,

Kathare

et al. 2024

European Journal of Ophthalmology

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Purpose To describe a case of acquired glaucomatous optic disc pit-related maculopathy successfully treated with glaucoma filtering surgery alone. Case description A 67-year-old male was diagnosed with advanced primary open angle glaucoma in both eyes, with a cup: disc ratio of 0.85 in the right eye and 0.95 in the left eye. Visual acuity at presentation was 20/60, and intraocular pressure was 14 mm Hg in the left eye. The fundus of the left eye revealed a serous macular retinal detachment due to an acquired optic disc pit. Results The left eye of the patient underwent combined cataract and glaucoma filtering surgery. The serous macular detachment resolved completely 15 months after surgery, with a documented visual acuity of 20/40 and intraocular pressure of 10 mm Hg without the use of additional antiglaucoma medications. There was no recurrence of serous macular detachment even after the two-year follow-up visit. Conclusion This case demonstrates that controlling intraocular pressure alone resulted in complete resolution of serous macular detachment in acquired optic disc pit maculopathy without the need for pars plana vitrectomy.

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Reversal of a glaucomatous optic disc pit

Cited by 3 publications

References 11 publications

Congenital versus acquired optic disc pit maculopathy: An OCT based study

Congenital versus acquired optic disc pit maculopathy: An OCT based study

Treating Acquired Optic Disc Pit Maculopathy with an Ocular Hypotensive Agent

Successful resolution of serous macular detachment following glaucoma-filtering surgery alone for acquired optic disc pit maculopathy

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