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 subretinal fluid. A complete ocular examination, including determination of visual acuity (VA), anterior and posterior biomicroscopy and optical coherence tomography (OCT) were performed.

Effectiveness/safety:

At initial presentation, VA was 0.2 (decimal scale) in his LE and 0.9 in her right eye (RE). Fundus examination revealed an optic disk pit with laser scars temporal to optic nerve head due to previous laser photocoagulation treatment and a serous retinal detachment involving the macular area which was confirmed by OCT. Furthermore, a colobomatous defect inferior to the optic nerve head was present. The patient underwent uneventful 20-gauge pars plana vitrectomy, internal limiting membrane peeling, fluid-air exchange and 15% sulfur hexafluoride (SF6) gas tamponade. A detailed fundus examination was obtained three weeks postoperatively when the gas had completely resorbed. VA was 0.2. Fundus examination revealed a flat retina, but OCT showed a lamellar macular hole. 28 months postoperatively, VA had increased to 0.5 and OCT showed complete resolution of intraretinal and subretinal fluid, but persistence of the lamellar macular hole.

Conclusions:

Vitrectomy with ILM peeling and gas tamponade seems to be effective for treatment of optic disc pit maculopathy, including those cases previously treated by laser. However, long-term complications after vitrectomy/ILM-peeling might occur, such as the development of a partial-thickness macular defect. Further studies are required to evaluate the current findings, although the implementation of large-series studies remain a challenge due to the rarity of cases with optic disc maculopathy.