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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

After revision of vitrectomy with gas tamponade, an SD-OCT scan of the same point made 1 week postoperatively (a) shows complete resolution of the retinal detachment and of the schisis-like separation of the outer layer, with a restitutio ad integrum of the foveal depression and of the external hyperreflective bands. A minimal amount of cystic fluid persists in the parafoveal outer layer, which could no longer be detected at 1 month (b).
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Figure 3: After revision of vitrectomy with gas tamponade, an SD-OCT scan of the same point made 1 week postoperatively (a) shows complete resolution of the retinal detachment and of the schisis-like separation of the outer layer, with a restitutio ad integrum of the foveal depression and of the external hyperreflective bands. A minimal amount of cystic fluid persists in the parafoveal outer layer, which could no longer be detected at 1 month (b).

Mentions: The patient then underwent revision of vitrectomy, fluid-air exchange with aspiration, and placement of gas tamponade. Postoperative SD-OCT scanning demonstrated that the sharp contour of the retinal elevation adjacent to the optic disc and inner retinoschisis-like separation were reduced immediately (fig. 3a) and BCVA improved to 20/25. These findings remained stable at 3 months after the second surgery (fig. 3b).


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)

After revision of vitrectomy with gas tamponade, an SD-OCT scan of the same point made 1 week postoperatively (a) shows complete resolution of the retinal detachment and of the schisis-like separation of the outer layer, with a restitutio ad integrum of the foveal depression and of the external hyperreflective bands. A minimal amount of cystic fluid persists in the parafoveal outer layer, which could no longer be detected at 1 month (b).
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 3: After revision of vitrectomy with gas tamponade, an SD-OCT scan of the same point made 1 week postoperatively (a) shows complete resolution of the retinal detachment and of the schisis-like separation of the outer layer, with a restitutio ad integrum of the foveal depression and of the external hyperreflective bands. A minimal amount of cystic fluid persists in the parafoveal outer layer, which could no longer be detected at 1 month (b).
Mentions: The patient then underwent revision of vitrectomy, fluid-air exchange with aspiration, and placement of gas tamponade. Postoperative SD-OCT scanning demonstrated that the sharp contour of the retinal elevation adjacent to the optic disc and inner retinoschisis-like separation were reduced immediately (fig. 3a) and BCVA improved to 20/25. These findings remained stable at 3 months after the second surgery (fig. 3b).

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