Limits...
Double-vitrectomy for optic disc pit maculopathy.

Pichi F, Morara M, Veronese C, Lembo A, Vitale L, Ciardella AP, Nucci P - Case Rep Ophthalmol (2012)

Bottom Line: It has been suggested that submacular fluid originates either from vitreous or cerebrospinal fluid.After ILM peeling, there was no improvement either in visual acuity or in the tomographic aspect of the retina.The absence of improvement after ILM peeling during the first surgical procedure, accompanied by resolution of the clinical picture with gas tamponade during the second surgical procedure, sustained the hypothesis of a subarachnoidal origin of the fluid.

View Article: PubMed Central - PubMed

Affiliation: San Giuseppe Hospital, University Eye Clinic, Milan, and Italy.

ABSTRACT

Background: The origin of the fluid and precise pathophysiology of optic pit maculopathy remain unclear. It has been suggested that submacular fluid originates either from vitreous or cerebrospinal fluid. We report a case of optic pit maculopathy which was unsuccessfully treated with vitrectomy and internal limiting membrane (ILM) peeling, and subsequently resolved with revision of vitrectomy and gas tamponade.

Methods: We report a case of optic disc pit maculopathy, well documented by spectral- domain optical coherence tomography, before and after pars plana vitrectomy with ILM peeling, and its revision with gas tamponade.

Results: After ILM peeling, there was no improvement either in visual acuity or in the tomographic aspect of the retina. A revision of the surgery was then needed and gas tamponade was performed, which resulted in a complete resolution of the optic pit maculopathy.

Conclusion: The absence of improvement after ILM peeling during the first surgical procedure, accompanied by resolution of the clinical picture with gas tamponade during the second surgical procedure, sustained the hypothesis of a subarachnoidal origin of the fluid.

No MeSH data available.


Related in: MedlinePlus

A fundus color photo shows a localized white/yellow oval depression in the inferotemporal segment of the optic disc and diffuse macular swelling. An SD-OCT scan through the fovea (a) shows cystic accumulation of fluid in the inner retinal layers adjacent to the disc, a schisis-like accumulation of fluid in the outer nuclear layer, and an underlying retinal detachment. This scan cannot detect any definite communication between the retinal separation and the optic nerve, but an SD-OCT scan taken at the inferior margin of the disc (b) shows a colobomatous pit of the nerve head.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
getmorefigures.php?uid=PMC3369255&req=5

Figure 1: A fundus color photo shows a localized white/yellow oval depression in the inferotemporal segment of the optic disc and diffuse macular swelling. An SD-OCT scan through the fovea (a) shows cystic accumulation of fluid in the inner retinal layers adjacent to the disc, a schisis-like accumulation of fluid in the outer nuclear layer, and an underlying retinal detachment. This scan cannot detect any definite communication between the retinal separation and the optic nerve, but an SD-OCT scan taken at the inferior margin of the disc (b) shows a colobomatous pit of the nerve head.

Mentions: An 89-year-old woman, followed in our Glaucoma Clinic for primary OAG in both eyes, was referred to our Retina Clinic for painless, progressive reduction of central vision and macular edema in her right eye. Her left eye had no light perception because of uncontrolled glaucoma. When first examined, her visual acuity was 20/200 in the right eye. An anomalous optic disc with an optic pit, focal peripapillary pigmentary changes, and diffuse macular swelling consistent with edema or retinoschisis were present (fig. 1).


Double-vitrectomy for optic disc pit maculopathy.

Pichi F, Morara M, Veronese C, Lembo A, Vitale L, Ciardella AP, Nucci P - Case Rep Ophthalmol (2012)

A fundus color photo shows a localized white/yellow oval depression in the inferotemporal segment of the optic disc and diffuse macular swelling. An SD-OCT scan through the fovea (a) shows cystic accumulation of fluid in the inner retinal layers adjacent to the disc, a schisis-like accumulation of fluid in the outer nuclear layer, and an underlying retinal detachment. This scan cannot detect any definite communication between the retinal separation and the optic nerve, but an SD-OCT scan taken at the inferior margin of the disc (b) shows a colobomatous pit of the nerve head.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC3369255&req=5

Figure 1: A fundus color photo shows a localized white/yellow oval depression in the inferotemporal segment of the optic disc and diffuse macular swelling. An SD-OCT scan through the fovea (a) shows cystic accumulation of fluid in the inner retinal layers adjacent to the disc, a schisis-like accumulation of fluid in the outer nuclear layer, and an underlying retinal detachment. This scan cannot detect any definite communication between the retinal separation and the optic nerve, but an SD-OCT scan taken at the inferior margin of the disc (b) shows a colobomatous pit of the nerve head.
Mentions: An 89-year-old woman, followed in our Glaucoma Clinic for primary OAG in both eyes, was referred to our Retina Clinic for painless, progressive reduction of central vision and macular edema in her right eye. Her left eye had no light perception because of uncontrolled glaucoma. When first examined, her visual acuity was 20/200 in the right eye. An anomalous optic disc with an optic pit, focal peripapillary pigmentary changes, and diffuse macular swelling consistent with edema or retinoschisis were present (fig. 1).

Bottom Line: It has been suggested that submacular fluid originates either from vitreous or cerebrospinal fluid.After ILM peeling, there was no improvement either in visual acuity or in the tomographic aspect of the retina.The absence of improvement after ILM peeling during the first surgical procedure, accompanied by resolution of the clinical picture with gas tamponade during the second surgical procedure, sustained the hypothesis of a subarachnoidal origin of the fluid.

View Article: PubMed Central - PubMed

Affiliation: San Giuseppe Hospital, University Eye Clinic, Milan, and Italy.

ABSTRACT

Background: The origin of the fluid and precise pathophysiology of optic pit maculopathy remain unclear. It has been suggested that submacular fluid originates either from vitreous or cerebrospinal fluid. We report a case of optic pit maculopathy which was unsuccessfully treated with vitrectomy and internal limiting membrane (ILM) peeling, and subsequently resolved with revision of vitrectomy and gas tamponade.

Methods: We report a case of optic disc pit maculopathy, well documented by spectral- domain optical coherence tomography, before and after pars plana vitrectomy with ILM peeling, and its revision with gas tamponade.

Results: After ILM peeling, there was no improvement either in visual acuity or in the tomographic aspect of the retina. A revision of the surgery was then needed and gas tamponade was performed, which resulted in a complete resolution of the optic pit maculopathy.

Conclusion: The absence of improvement after ILM peeling during the first surgical procedure, accompanied by resolution of the clinical picture with gas tamponade during the second surgical procedure, sustained the hypothesis of a subarachnoidal origin of the fluid.

No MeSH data available.


Related in: MedlinePlus