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 including visual acuity testing (VA), anterior and posterior biomicroscopy and optical coherence tomography (OCT) were performed in both cases.

Effectiveness/safety:

At presentation, VA was 0.5 in the LE, and 1.0 in the RE (decimal chart) of case 1. VA was 0.5 in RE, and 1.0 in LE in case 2. Fundus examination showed an optic disk pit and a serous retinal detachment involving the macular area in both cases, case 2 also had yellow deposits. An inferior colobomatous defect could also be observed in case 2. OCT confirmed the diagnosis in both patients. Laser photocoagulation at the border of the optic nerve was performed twice in both cases with an interval of 6 months in case 1 and 2 months in case 2. Follow-up was 13 months for case 1 and 17 months for case 2. During final examination VA was 0.5 in case 1 and 0.8 in case 2. In both cases, fundus examination and OCT revealed a partial resolution of serous retinal detachment, but not a complete disappearance of fluid.

Conclusion:

Optic disc pit is a rare finding that occurs in <0.01% of ophthalmology patients. It may be associated with a large optic nerve head, inferior colobomatous changes of the optic disc and inferonasal retinal colobomata supporting the hypothesis that the optic disc pit develops from incomplete closure of the inferior embryonic fissure. Up to two-thirds of patients with optic disc pits have blurred vision due to serous macular detachment that starts at the edge of the pit and may extend into the fovea. With chronic serous detachment, precipitates may occur on the posterior surface of the retina (see case 2), and chronic cystoid changes appear in the fovea. The source of the subretinal fluid is controversial. It has been suggested that the detachment may be due to vitreous fluid that has access to the subretinal space via the optic pit. Various treatment options have been reported that include laser photocoagulation with or without intravitreal gas or silicone oil tamponade. Resolution of subretinal fluid after photocoagulation alone have been reported, but resorption might take up to 6 months. Possilbe adverse effects of laser photocoagulation near the disc include paracentral scotomas and lack of of visual improvement and failure of resolution of serous macular detachment.