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Managing Optic Pit – The Right Stuff !

A video showing how the authors have used various techniques to manage optic pit with vitrectomy over the past 15 years. Surgical modifications to standard vitrectomy are shown and the authors comment on the various techniques used and the results obtained. They also refer to the literature, which prompted them to develop a new approach to treat the condition. The latest modification involves “stuffing” the optic pit – with...

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Spontaneous Regression of Optic Disc Pit Related Maculopathy by the Time

Mehmet Demir_SCIENTIFIC POSTER 2015_2 Aim: To report spontaneous regression of optic disc pit related maculopathy associated with low vision and retinal tissue defect in a middle age woman. Methods: A 38-year-old female was admitted with low vision in the left eye. She had no significant refractive error in both eyes. Best corrected visual acuity (BCVA), intraocular pressure (IOP), anterior and posterior segments were evaluated. Optical...

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Optic Pit Surgical Successful Management: Follow-up of 5 Years

SCIENTIFIC POSTER_Pedro Neves Introduction: Optic pits are congenital anomalies of the optic disc of unknown pathophysiology. About 45% are associated with either macular retinoschisis or serous retinal detachments. Peripapillary vitreous traction has been proposed to be involved and vitrectomy is reported as an effective therapy, with induction of posterior vitreous detachment even without gas tamponade or laser photocoagulation. Case...

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Management of Maculopathy Associated with Optic Pit and Coloboma of teh Optic Disc

SCIENTIFIC POSTER_Carlos Menezes Purpose: To report our outcomes in the management of optic pit disc and optic nerve coloboma associated maculopathy. Methods: We report 3 cases of optic disc pits and a rare case of temporal optic disc coloboma followed in consult in our hospital. Three of them developed macular detachment and of these, two were proposed to pars plana vitrectomy with internal limiting membrane peeling, peripapillary laser...

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Success and Drawbacks in the Treatment of Bilateral Optic Pits

Media not available due to technical recording problems. EVRS is very sorry for the inconvenience.   A then 6 yr old girl presented with a bilateral optic pit and a severe retinal detachment with PVR in her left eye. Pars plana vitrectomy with silicone oil could only temporarily restore anatomical attachment. 10 years later visual acuity deteriorated also in the right eye from 0.6 to 0.2 due to a central serous detachment and an...

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Optic Pit in Pediatric Age Group

Media not available due to technical recording problems. EVRS is very sorry for the inconvenience.   Purpose: To demonstrate two cases of optic nerve pit in paediatric age group. Methods and results: A one-year old female with skin and mucous membrane manifestations of tuberous sclerosis was found to have an optic nerve pit with subretinal fluid OS and astrocytic hamartomas OD. Over a follow up period of 3 years, the patient had stable...

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Spontaneous Resolution of Optic Pit Detachment in a Child: Case Report

Media not available due to technical recording problems. EVRS is very sorry for the inconvenience.   The Optic Disc Pit (ODP) is a rare congenital defect of the optic nerve disc which involves the macular region in 75-93% of the affected adults, and more rarely in children. In our case report we studied the morphological variations in a 6 year old child with ODP associated with serous detachment of the neuroepithelium, intraretinal...

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My Way in Recurrent Optic Pit Maculopathy

Media not available due to technical recording problems. EVRS is very sorry for the inconvenience.   My standard approach to macular detachment associated to optic pit is vitrectomy with posterior hyaloid removal, ILM peeling with or without laser temporal to optic nerve head and gas as a first line treatment. In case of recurrence of macular detachment, I usually use ILM flaps around the optic nerve head to use as a seal over the pit...

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Surgery for Optic Pit with Macular Schisis/Detachment

Media not available due to technical recording problems. EVRS is very sorry for the inconvenience.   Advantages: To demonstrate an effective technique towards successful optic pit surgery. Methods: 17 eyes were operated on between 1999-2013 17 eyes with vitrectomy, PVD, ILM-peeling, laser around the pit and gas tamponade. Follow-up was 42-3610 days (median 762). OCT-imaging was available for 11 cases (2003 and later). Two examples...

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Optic Pit Maculopathy. Is There a Role for Autologous Plasmin?

Media not available due to technical recording problems. EVRS is very sorry for the inconvenience.   Case report: To report an unexpected resolution of the optic pit maculopathy in a young adult after intravitreal injection of autologous plasmin. Pharmacological vitreolysis, also known as enzymatic vitrectomy utilizing autologous plasmin or microplasmin has been utilized in vitreomacular traction syndromes alone or as a coadjutant...

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Strategy for the Management of Optic Pit Maculopathy

Media not available due to technical recording problems. EVRS is very sorry for the inconvenience.   Advantages: To report the effectiveness of vitrectomy and adjunct procedures in the resolution of the serous retinal detachment secondary to optic pit. Methods: Eleven patients with macular detachment underwent three ports standard vitrectomy with induction of posterior vitreous detachment, ILM peeling, laser photocoagulation at the...

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Clinical Outcomes After PPV Without ILM Peeling and Laser Photocoagulation in Optic Pit RD

Media not available due to technical recording problems. EVRS is very sorry for the inconvenience.   Advantages: To evaluate visual and anatomical outcomes after surgical treatment of serous macular detachment associated with optic disc pit without using laser photocoagulation or internal limiting membrane peeling. Methods: 5 eyes of 5 patients with serous macular detachment associated with congenital optic disc pit have been...

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Vitrectomy / ILM Peel / Gas / No Laser for Optic Disc Pit Associated Macular Hole

Media not available due to technical recording problems. EVRS is very sorry for the inconvenience.   Purpose: To evaluate the efficacy of vitrectomy, ILM peel and gas tamponade without laser photocoagulation in a case of macular hole associated with optic disc pit. Case description: A 51 year old female presented with blurring of central vision in left eye for the last six months. BCVA RE 6/6, LE 6/60 and IOP was 16 mm Hg in either...

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My Management of Optic Pit Retinal Detachment

Media not available due to technical recording problems. EVRS is very sorry for the inconvenience.   The management of retinal detachment secondary to optic pit is still debated. My management consist of gas injection of 0.4 cc of pure SF6, face down positioning for 3-4 days, laser one week after gas injection. This strategy may solve or improve the retinal detachment. I counsel vitrectomy with ILM peeling and laser only when the first...

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My Way for Optic Pit RD

Media not available due to technical recording problems. EVRS is very sorry for the inconvenience.   My concept of mini-invasive surgery leads me to propose the following strategy: during the evening before the operation, I perform 2 raws of photocoagulation with red laser along the temporal size of the optic pit, in the detached retina; during the following morning I make an anterior chamber drainage followed by a 0.4 ml of C3F8...

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Pneumatic Retinopexy in Optic Pit Macular Detachment

Media not available due to technical recording problems. EVRS is very sorry for the inconvenience.   Purpose: To show the efficacy and safety of miniinvasive method of pneumatic retinopexy in cases of optic pit macular detachment. Setting venue: The prospective study. Materials and methods: 15 patients (15 eyes) with optic pit macular detachment aged 11-32 years with VA less than 0.1 underwent the pneumatic retinopexy by intravitreal...

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Optic Pit Maculopathy First Treated with Laser and Finally Resolved with Vitrectomy. Long-term Evaluation

SCIENTIFIC POSTER_Miriam Garcia Fernandez_5 Advantages: To describe a case of an optic disk pit treated with vitrectomy, and to report the long-term results. Methods: A 16-year-old female patient complained of progressive diminution of vision in the left eye (LE) for one month due to an optic disc pit with macular edema. Three years before laser photocoagulation had been performed and resulted in incomplete resolution of macular edema and...

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Laser Photocoagulation for Optic Pit Macular Detachment: Report of Two Cases

SCIENTIFIC POSTER_Miriam Garcia Fernandez_4 Advantages: To describe two cases with optic pit maculopathy treated by laser photocoagulation and report the final outcomes. Methods: A 48-year-old male patient presented with visual loss for 6 months in his left eye (LE) (CASE 1), and a 27-year-old female patient with complaint of progressive visual acuity diminution for 3 months in her right eye (RE) (CASE 2). A complete ocular examination...

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Intravitreal Gas + Laser with Topical Ketorolac Tromethamine and Brinzolamide Therapy for Optic Pit Maculopathy

Purpose: To report the result of treatment with intravitreal gas injection plus laser photocoagulation and topical brinzolamide and ketorolac in a young woman with optic pit-associated maculopathy. Methods: A 21 year-old myopic female was referred with blurred vision in the left eye. Best-corrected visual acuity was 0.05 on the left and 1.0 on the right eye (Snellen chart). Intraocular pressure was 17/15 mm Hg in the right and left eye,...

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Enhanced Depth Imaging OCT in Optic Pit Maculopathy Supports the Theory of Cerebrospinal Fluid

Advantages: The source of the subretinal fluid under the macula in patients with optic disc pit (ODP) has remained a controversial subject. Various theories exist about the onset of maculopathy: fluid entry either from the vitreous cavity or from leakage of cerebrospinal fluid through the peripapillary subarachnoid space. To date, OCT studies had not revealed any communication between the subretinal fluid and the peripapillary subaracnoid...

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Different Surgical Solutions for Optic Pit Maculopathy

In this video step-by-step surgical solutions to optic pit related macular detachment are presented. We show vitrectomy with posterior hyaloid removal, ILM peeling, laser PK temporal to optic nerve head and gas as a first line treatment. ILM flaps around the optic nerve head to use as a seal over the pit as a second line treatment and using autologous fibrin to seal the pit as a third line treatment in recurrent macular detachments. We...

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Could the Volume of Retinoschisis Near Optic Pit Be an Early Indicator for Intravitreal Gas Re-injection?

RETINA PHOTO_Yong Seop Han Purpose: To report the clinical outcome after C3F8 gas tamponade without vitrectomy for retinal detachment associated with an optic disk pit using sequential optical coherence tomography. Furthermore, to discuss whether the volume of retinoschisis near optic disk pit could be an early indicator for intravitreal gas re-injection in patient with optic pit maculopathy. Methods: Intravitreal gas injection was...

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Etiology and Treatment of Serous Macular Detachment Associated with Optic Pit – Clinical Case

Optic Pits are congenital excavations of optic nerve “head” that may be associated with other optic nerve and peripapillary retina anomalies. They occur in 1/10.000 people, both male and female. More than two thirds of patients develop serous macular detachment with loss of vision. There is controversy about the etiology and nature of maculopathy in these cases. Clinical Case: Female patient observed due to painless loss of...

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Treatment of Optic Pit Maculopathy with Vitrectomy and Arcuate ILM Peeling

Advantages: To present the results of vitrectomy, laser and arcuate ILM peeling at the temporal margin of the optic nerve and air tamponade. Methods: 9 patients with symptopatic maculopathy associated with optic disc pit were treated between 2008 and 2011. Surgical technique consisted of central vitrectomy, posterior hyaloid detachment, laser treatment at the temporal margin of the optic disc and ILM peeling at the temporal margin of...

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Natural Course of Disc Pit

Advantages: Our purpose was to study the clinical course of optic pit maculopathy using spectral optical coherence tomography (OCT) images, and to discuss possible ways of fluid entrance into the subretinal space. Methods: 11 eyes with a macular detachment in combination with an optic pit were examined using spectral OCT, with axial resolution 3-6µm. In selected cases, fluorescein angiography and scanning laser ophthalmoscopy were...

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Ranibizumab for Residual Exudative Macular Detachment After PPV for Congenital Optic Pit

Advantages: Efficiency of surgical treatment of a macular detachment associated with an optic disc pit makes 63-100 %. However, possible recurrence of the disease and long (till 12 months) period of resorption of subretinal liquid after vitrectomy are, probably, responsible for the low functional results of operations. Methods: The purpose of our research was studying of efficiency of intravitreal injections in treatment for residual...

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Implantation of Biomaterial (Masoud, Bio- balloon) to Vitreous Cavity for the Treatment of Macular Hole After Vitrectomy

Mehran Masoudnaseri (Odessa, Ukraine) Advantages: To treat and prevent postoperative complications with implantation of intraocular bio balloon after vitrectomy in aphakic and pseudophakic eyes with macular hole in retinal detachment. Methods: After vitrectomy the spatial syringe with gas or BSS (Fig 1A) with fixed bio balloon on it (v.4-6 mm) (fig 2A) injected through the ora serrata into the vitreous cavity (fig 3A). Then we filled the...

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Treatment of Optic Pit Related Macular Detachment

Sengul Ozdek (Ankara, Turkey) Advantages: PPV with ILM peeling +/- laser for the treatment of optic pit related macular serous detachment. Effectiveness / Safety: Case 1 is a 68y old female with optic pit related macular detachment. Ophthalmic examination revealed a visual acuity (VA) of CF at 3m. Following PPV with ILM peeling and SF6 (20%) gas tamponade, serous detachment persisted during 2 wk post-op visit, which was totally resolved...

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Optic Nerve Pit with Macular Detachment (Fluid Origin and Better Management)

Ehab El Rayes (Cairo, Egypt) Advantages: Vitrectomy with intra as well as submacular fluid aspiration leads to more favorable outcome and the nature of the fluid has C.S.F. content. Methods: We report 6 eyes of 4 patients with macular detachment due to optic nerve pits. 2 eyes were managed with vitrectomy, laser and air. The other 4 eyes were treated with vitrectomy and aspiration of the viscous intra as well as subretinal fluid with...

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Retinal Hole Closure in Optic Nerve Coloboma After Autologous Platelet Concentrate Injection: A Case Report

Elisa Carreras*, Jeroni Nadal, Paola Sauvageot, Marta López-Fortuny, Maria Isabel Canut (Barcelona, Spain) Advantages: Autologous platelet concentrates injection as treatment of retinal hole in optic nerve coloboma. Methods: We report the case of a 20-year old patient with recurrent retinal detachment (RD) secondary to optic nerve coloboma, previously treated with vitrectomy, photocoagulation of the temporal edge and gas tamponade....

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Minimally Invasive Surgery in Optic Nerve Pit Associated with Serous Macular Detachment

Veronika Aslanova *, Nikolai Umanets, Olena Ivanitskaya (Odessa, Ukraine) Advantages: Pneumatic retinopexy in cases of optic nerve pit associated with serous macular detachment is the most minimally invasive surgery that can be successfully performed in this pathology. Methods: The results of pneumatic retinopexy in 6 patients (6 eyes) with congenital optic nerve pit and macular detachment were analyzed. Age of the patients was from 11 to...

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Delayed Resolution of Serous Macular Detachment Associated with Optic Disc Pit After Vitrectomy, Laser Photocoagulation, and Gas Tamponade

Salim Ben Yahia*, Rim Kahloun, Ghassen Laadhari, Ahmed Mahjoub, Sonia Attia, Moncef Khairallah (Monastir, Tunisia) Advantages: To manage serous macular detachment associated with optic disc pit with vitrectomy, laser photocoagulation to the margin of the optic disc, and gas tamponade. Methods: An 18-year-old female with serous macular detachment associated with a congenital optic pit underwent pars plana vitrectomy, induction of posterior...

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Surgical Outcomes of Serous Macular Detachment Associated with Optic Disc Pit

Yaprak Banu Ünver*, Ziya Kapran, Nur Acar, Yapar Kucuksumer (Istanbul, Turkey) Advantages: To evaluate anatomic and functional outcomes of serous macular detachment associated with optic disc pit following vitrectomy and gas tamponade injection. Methods: Six patients with unilateral optic disc pit maculopathy were included in this study. Preoperatively median best-corrected visual acuity (BCVA) was 20/800 (20/125-20/1000). All patients...

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Treatment of Retinal Detachment Secondary to Optic Pit with Autologous Platelet Concentrate

Authors: Jeroni Nadal, Barbara Delas, Rodrigo Abreu, Barcelona, Spain Advantages: No retinal laser scars. We are presenting a prospective study about 12 cases affected by retinal detachment in the posterior pole secondary to an optic pit. All patients were treated by means of vitrectomy, posterior hyaloid peeling and air exchange, application on the surface del II par of 0.05 ml autologous platelets concentrate and exchange with 15%  C3F8,...

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Optic Pit Maculopathy-Diagnosis with Spectral OCT and its Implications for Treatment

http://www.evrs.eu/medias/2009/videos/JerzyNawrocki_3_VP6_768K.flv Authors: Jerzy Nawrocki, Zofia Nawrocka, Janusz Michalewski, Zofia Michalewska, Lodz, Poland Advantages: Spectral OCT was used to analyze surgical images of optic pit maculopathy. Methods: Vitrectomy with air tampodane was performed in 4 eyes and with silicone oil tampodane in one eye. One patient was followed up who decided against surgery. Effectiveness / Safety: SOCT...

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Evolution of Surgical Technique in Management of Optic Disc Pit Maculopathy

Authors: Paolo M. Fantaguzzi, Edlira Bendo, Daniele Corazza, Forli, Italy Advantages: The surgical management of optic disc pit maculopathy is still controversial. We report the evolution of different vitrectomy approach in the treatment of optic disc pit associated maculopathy in 4 patients. Methods: The principal treatment in all cases was PPV (Pars Plana Vitrectomy) 20 or 25 gauge (last patient) with ILM peeling and tamponade with...

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Optic Pit Retinal Detachments – Attempt at a Unifying Theory

Klaus Lucke, MB ChB (Bremen, Germany), Silvia Bopp, MD (Bremen, Germany) PURPOSE: The pathogenesis of optic pit retinal detachments, particularly the source of the subretinal fluid continues to be controversial. Vitreous traction, full thickness retinal defects or a communication channel to the subarachnoid space have been proposed. The purpose of this paper is to present a collection of instructive cases which suggest a diversity of...

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Temporal Radial Optic Neurotomy (RON) for Optic Disc Pit Associated with Macular Detachment

Murat Karacorlu, Hakan Ozdemir, Serra Arf Karacorlu, Fevzi Senturk Purpose: To determine the effectiveness of temporal radial optic neurotomy for optic disc pit associated with inner retinal layer separation and outer layer detachment. Case Report: We report on a 38-year old woman with optic disc pit associated with inner retinal layer separation and outer layer detachment. The patient underwent an uneventful pars plana vitrectomy with...

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Vitrectomy for Optic Pit-Related Retinal Detachment

Ferenc Kuhn, Robert Morris, Viktoria Mester Purpose: To present an effective intraocular approach for the treatment of eyes with optic pitrelated retinal detachment. Methods: Retrospective case series. Results: Twenty-one eyes underwent pre- or intraoperative laser (L) at the disc margin, complete vitrectomy (V), including separation and removal of the posterior hyaloid face, and gas tamponade (G) with postoperative positioning “LVG...

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Treatment of Macular Detachment in Patients with Optic Pit

http://www.evrs.eu/medias/2005/congress/Treatment-of-macular-detachment-in-patients-with-optic-pit.swf Sven Crafoord Purpose: To report the clinical outcome, of patients with congenital optic pit and macular retinal detachment, using vitrectomy, retinotomy and drainage of subretinal fluid with or without retinopexy or ILM peeling. Methods: 17 consecutive patients with macular off retinal detachments and optic pit were enrolled in the study...

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