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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

An SD-OCT scan through the fovea taken 4 weeks after the first surgical procedure (pars plana vitrectomy and ILM peeling) (a) shows a slight reduction of the inner retinal cysts near the disc, whereas the outer layer schisis-like separation and the retinal detachment did not improve. Moreover, an outer layer macular hole developed beneath the schisis. The decrease in central retinal thickness of 164 μm (b) is rather due to a displacement of the fluid than to reabsorption of it.
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Figure 2: An SD-OCT scan through the fovea taken 4 weeks after the first surgical procedure (pars plana vitrectomy and ILM peeling) (a) shows a slight reduction of the inner retinal cysts near the disc, whereas the outer layer schisis-like separation and the retinal detachment did not improve. Moreover, an outer layer macular hole developed beneath the schisis. The decrease in central retinal thickness of 164 μm (b) is rather due to a displacement of the fluid than to reabsorption of it.

Mentions: Spectral-domain (SD)-OCT examination at 1 week and 1 month postoperatively (fig. 2) did show a slight decrease of retinal thickness (fig. 2b) consistent with a slight reabsorption of the cystic fluid in the inner retinal layers nasally to the macula; however, the retinal detachment persisted and, additionally, an outer layer macular hole developed beneath the inner layer (fig. 2a). Accordingly, the patient's BCVA remained stable at 20/200.


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)

An SD-OCT scan through the fovea taken 4 weeks after the first surgical procedure (pars plana vitrectomy and ILM peeling) (a) shows a slight reduction of the inner retinal cysts near the disc, whereas the outer layer schisis-like separation and the retinal detachment did not improve. Moreover, an outer layer macular hole developed beneath the schisis. The decrease in central retinal thickness of 164 μm (b) is rather due to a displacement of the fluid than to reabsorption of it.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 2: An SD-OCT scan through the fovea taken 4 weeks after the first surgical procedure (pars plana vitrectomy and ILM peeling) (a) shows a slight reduction of the inner retinal cysts near the disc, whereas the outer layer schisis-like separation and the retinal detachment did not improve. Moreover, an outer layer macular hole developed beneath the schisis. The decrease in central retinal thickness of 164 μm (b) is rather due to a displacement of the fluid than to reabsorption of it.
Mentions: Spectral-domain (SD)-OCT examination at 1 week and 1 month postoperatively (fig. 2) did show a slight decrease of retinal thickness (fig. 2b) consistent with a slight reabsorption of the cystic fluid in the inner retinal layers nasally to the macula; however, the retinal detachment persisted and, additionally, an outer layer macular hole developed beneath the inner layer (fig. 2a). Accordingly, the patient's BCVA remained stable at 20/200.

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