Vitrectomy for macular detachment associated with optic nerve pits

Bartz‐Schmidt, Karl Ulrich; Heimann, Klaus; Esser, Peter

doi:10.1007/bf00130850

Cited by 24 publications

(16 citation statements)

References 35 publications

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“…Intraoperative observations during vitrectomy for the treatment of optic disc pit maculopathy emphasize the role of the vitreoretinal interface in the pathogenesis of macular detachment associated with optic disc maculopathy in a number of case reports [2,3,7,12,14,16,18]. Moreover the good surgical results after the release of vitreous traction by vitrectomy [8,15] or scleral buckling procedure [32,35] further strengthens the view that the vitreous participates in the pathogenesis of the optic disc pit maculopathy.…”

Section: Discussionmentioning

confidence: 51%

Vitreous findings in optic disc pit maculopathy based on optical coherence tomography

Theodossiadis¹,

Grigoropoulos

Emfietzoglou

et al. 2007

Graefes Arch Clin Exp Ophthalmol

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OCT was able to detect vitreous abnormalities such as vitreomacular traction, vitreous strands over the optic disc and complete or partial posterior vitreous detachment associated with optic disc pit maculopathy. Our observations support the view that the abnormal vitreous over the macula and optic disc is likely to play a role in the development of macular elevation in cases with optic disc pit. Prospective OCT studies could further assist to better understand the role of vitreous in this disease.

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Section: Discussionmentioning

confidence: 51%

Vitreous findings in optic disc pit maculopathy based on optical coherence tomography

Theodossiadis¹,

Grigoropoulos

Emfietzoglou

et al. 2007

Graefes Arch Clin Exp Ophthalmol

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“…This was initially reported anecdotally [65, 66], and later supported by two different series of 11 patients [37, 67]. García-Arumí et al [67] reported on 11 ODP-M patients treated with PPV, induction of PVD, laser and gas tamponade, achieving anatomical resolution and significant visual improvement in all cases, with only 2 recurrences.…”

Section: Reviewmentioning

confidence: 80%

“…It has been proposed that induction of complete PVD during surgery is essential for relief of traction required to achieve macular reattachment [65]. This was initially reported anecdotally [65, 66], and later supported by two different series of 11 patients [37, 67].…”

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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“…Cox et al 34 reported prompt and sustained macular reattachment, with improved vision, after photocoagulation, vitrectomy, and gas tamponade in eight patients, although four required second operations. There have been numerous reports of treatment with vitrectomy, laser, and gas, 33,35,[38][39][40][41][42] some advocating removal of the posterior hyaloid or inner limiting membrane; [43][44][45][46] and one the use of autologous platelets. 47 One centre treated nine consecutive patients with a macular buckling procedure.…”

Section: Treatmentmentioning

confidence: 99%

Intraocular surgery for optic nerve disorders

Poulson

Snead

Jacobs

et al. 2004

Eye

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This article discusses two current indications for intraocular surgery for optic nerve conditions. The first topic is macular detachment in association with congenital optic disc pit, and includes a review of the theories of pathogenesis and management options including our own experience of treatment with vitrectomy and gas tamponade. In addition, the histopathological findings of a new case of optic disc pit with serous macular detachment are presented, adding to the rare examples previously reported. The second subject is a radial optic neurotomy, a recently advocated treatment for central retinal vein occlusion, which, despite its controversial nature, is gaining in popularity.

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Vitrectomy for macular detachment associated with optic nerve pits

Abstract: We recommend the removal of the posterior hyaloid face during pars plana vitrectomy in patients with central macular detachment associated with a pit of the optic disc.

Cited by 24 publications

References 35 publications

Vitreous findings in optic disc pit maculopathy based on optical coherence tomography

Vitreous findings in optic disc pit maculopathy based on optical coherence tomography

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

Intraocular surgery for optic nerve disorders

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