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 performed on 19-year-old man with unilateral macular detachment associated with an optic disk pit. The patient had unilateral optic pit on left eye. A 0.3ml injection of 100% octafluoropropane (C3F8) gas was carried out four times during the course of treatments. Each intravitreal gas injection was carried out with anterior chamber tab. Patients treated with gas injection were instructed to remain facedown for 5 days each time. Best-corrected visual acuity was recorded. Indirect fundoscopy and slit-lamp biomicroscopy, using a 90-diopter noncontact lens, were performed before and after gas injection. To investigate posterior retinal changes during the follow-up, OCT images of the eye were obtained using Spectralis OCT (Heidelberg Engineering, Heidelberg, Germany). Fundus photography of the posterior pole was taken with a digital fundus camera connected to an image acquisition system.

Results:

Retinal detachment was reduced after twice injecting with intravitreal gas and the volume of retinoschisis near optic disk pit decreased. Four weeks after second intravitreal C3F8 gas injection, the volume of retinoschisis near optic disk pit increased without aggravation of retinal detachment. Intravitreal gas re-injection was conducted because the author assumed that the increased volume of retinoschisis could be an early indicator of deterioration of retinal detachment. Since last intravitreal gas injection, this case showed reduction of the retinoschisis-like change and retinal detachment.

Conclusion:

In the present case, gas tamponade appears to be an effective alternative method for macular detachment associated with an optic disk pit. The volume of retinoschisis near optic disk pit may be an early indicator for intravitreal gas re-injection.