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Vitrectomy for optic disc pit maculopathy: a long-term follow-up study

  • Retinal Disorders
  • Published:
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Abstract

Purpose

To evaluate the clinical outcomes of vitrectomy with induction of posterior vitreous detachment for the treatment of optic disc pit maculopathy.

Methods

We retrospectively evaluated medical records and imaging studies of 11 consecutive patients with optic disc pit maculopathy who underwent vitrectomy at Sacco University Hospital, Milan, Italy, between October 2008 and December 2015. Induction of a posterior vitreous detachment (PVD) was the aim of our surgery. Intravitreal injection of ocriplasmin (Jetrea, Thrombogenics USA, Alcon/Novartis EU) was performed before surgery in three eyes of very young patients. Gas tamponade (sulfur hexafluoride (SF6) 20%) was used only in the first five cases. Main outcome measures were anatomic results as determined by optical coherence tomography and postoperative best-corrected visual acuity (BCVA).

Results

Before surgery, a macular detachment was present in 10 eyes and a lamellar hole of the outer retina was detected in 9 eyes. Intraoperatively, two iatrogenic paramacular holes developed in two patients during posterior hyaloid dissection. Time to PVD induction appeared to be greatly reduced in the three patients injected with ocriplasmin before surgery. Patients were followed up for a mean of 38 months (range, 18–84) after surgery. Postoperatively, one patient (9%) developed a retinal detachment that was repaired with one additional vitrectomy. Complete resolution of fluid in and under the fovea was achieved in 8 of the remaining 10 eyes (80%) without additional treatment. Reduction of the inner retinal fluid always preceded the decrease of outer retinal fluid, which in turn anticipated the absorption of macular detachment. The macular detachment resolved in a mean of 14 months after surgery. Postoperative BCVA (mean, 0.63) improved significantly compared with preoperative BCVA (mean, 0.27) (P = 0.005). Nine eyes (82%) had a postoperative BCVA of 0.5 or better.

Conclusion

Vitrectomy with induction of PVD is a safe and successful therapeutic option for the treatment of optic disc pit maculopathy. The adjunct of ocriplasmin might facilitate the induction of PVD and reduce the risk of iatrogenic retinal holes.

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Funding

This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

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Authors and Affiliations

  1. Eye Clinic, Department of Clinical Science “Luigi Sacco”, Sacco Hospital, University of Milan, Milan, Italy

    Ferdinando Bottoni, Matteo Cereda, Roberta Secondi, Sara Bochicchio & Giovanni Staurenghi

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  1. Ferdinando Bottoni
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  2. Matteo Cereda
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  3. Roberta Secondi
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  4. Sara Bochicchio
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  5. Giovanni Staurenghi
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Correspondence to Ferdinando Bottoni.

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All authors declare that they have no competing interests.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

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Bottoni, F., Cereda, M., Secondi, R. et al. Vitrectomy for optic disc pit maculopathy: a long-term follow-up study. Graefes Arch Clin Exp Ophthalmol 256, 675–682 (2018). https://doi.org/10.1007/s00417-018-3925-9

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  • DOI: https://doi.org/10.1007/s00417-018-3925-9

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