Abstract
Optic disc pit (ODP) is a rare congenital defect within the optic nerve head. Macula elevation associated with ODP develops in 75–93% of the adult patients. Macular involvement in children with optic disc pit is rare, and only a few cases have been published to date. In the present case, we have observed morphology and function of the central retina in a child with ODP-associated macular detachment and following its spontaneous resolution. An 8-year-old white boy diagnosed with a macular detachment in an eye with an ODP. Optical coherent tomography (OCT) and multifocal electroretinography (mfERG), as well as visual acuity and visual field, were performed in the follow-up of the unilateral schisis—like retinal detachment. A large retinoschisis associated with ODP in a child showed a tendency to spontaneously resolve at 3 months, which was confirmed on OCT. At this time, an mfERG revealed markedly reduced responses. Despite morphologic reattachment at follow-up and improvement in visual acuity, increased mfERG responses were still not the same as in the fellow healthy eye. In contrast to the OCT which is very helpful to assess the extent of the neurosensory detachment, the mfERG offers an additional tool for follow-up of retinal function in this disorder. The good visual outcome in our patient shows that in the presence of residual retinal function on mfERG and in the absence of further lesions on OCT, follow-up is a valid option in children with an ODP-associated macular detachment.
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References
Theodossiadis G, Theodossiadis P, Malias J, Moschos M, Moschos M (2002) Preoperative and postoperative assessment by multifocal electroretinography in the management of optic disc pit with serous macular detachment. Ophthalmology 109:2295–2302
Ghosh YK, Banerjee S, Konstantinidis A, Athanasiadis I, Kirkby GR, Tyag AK (2008) Surgical management of optic disc pit associated maculopathy. Eur J Ophthalmol 18:142–146
Lincoff H, Lopez R, Kreissig I, Yannuzzi L, Cox M, Burton Th (1988) Retinoschisis associated with optic nerve pits. Arch Ophthalmol 106:61–67
Lincoff H, Kreissig I (1998) Optical coherence tomography in pneumatic displacement of optic disc pit maculopathy. Br J Ophthalmol 82:367–372
Brown GC, Schields JA, Goldberg RE (1980) Congenital pits of the optic nerve head. II. Clinical studies in humans. Ophthalmology 87:51–65
Yuen CHW, Kaye SB (2002) Spontaneous resolution of serous maculopathy associated with optic disc pit in child: a case report. J AAPOS 5:330–331
Ishikawa K, Terasaki H, Mori M, Sugita K, Miyake Y (2005) Optical coherence tomography before and after vitrectomy with internal limiting membrane removal in child with optic disc pit maculopathy. Jpn J Ophthalmol 49:411–413
Georgalas I, Kouri A, Ladas I, Gotzaridis E (2010) Optic disc pit maculopathy treated with vitrectomy, internal limiting membrane peeling, and air in a 5-year-old boy. Can J Ophthalmol 45:189–191
Hood DC, Bach M, Brigell M, Keating D, Kondo M, Lyons JS, Palmowski-Wolfe AM (2008) ISCEV guidelines for clinical multifocal electroretinography (2007 edition). Doc Ophthalmol 116:1–11
Georgalas I, Ladas I, Georgopoulos G, Petrou P (2011) Optic disc pit: a review. Graefes Arch Clin Exp Ophthalmol 249:1113–1122
Gass JDM (1969) Serous detachment of the macular secondary to congenital pit of the optic nerve head. Am J Ophthalmol 67:821–841
Irvine AR, Crawford JB, Sullivan JH (1986) The pathogenesis of retinal detachment with morning glory disk and optic pit. Retina 6:146–150
Ferry AP (1963) Macular detachment associated with congenital pit of the optic nerve head; pathologic findings in tow cases simulating malignant melanoma of the choroid. Arch Ophthalmol 70:346–357
Sugar HS (1964) An explanation for the acquired macular pathology associated with congenital pits of the optic disc. Am J Ophthalmol 57:833–835
Gordon R, Chatfield RK (1969) Pits in the optic disc associated with macular degeneration. Br J Ophthalmol 53:481–489
Hirakata A, Hida T, Wakabayashi T, Fukuda M (2005) Unusual posterior hyaloids strand in young child with optic disc pit maculopathy: intraoperative and histopathological findings. Jpn J Ophthalmol 49:264–266
Snead MP, James N, Jacobs PM (1991) Vitrectomy, argon laser and gas tamponade for serous retinal detachment associated with an optic disc pit: a case report. Br J Ophthalmol 75:381–382
Chappelow AV, Marmor M (2000) Multifocal electroretinogram abnormalities persist following resolution of central serous chorioretinopathy. Arch Ophthalmology 118:1211–1215
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Swiss National Science Foundation (SNSF) 32003B-135219.
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No conflicting relationship exists for any author. The author(s) have no proprietary or commercial interest in any materials discussed in the article.
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This report has been partly presented as a poster at the Conference “Developments in Visual Science: Function meets Morphology” on June 9–11, 2010, Munich, Germany.
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Polunina, A.A., Todorova, M.G. & Palmowski-Wolfe, A.M. Function and morphology in macular retinoschisis associated with optic disc pit in a child before and after its spontaneous resolution. Doc Ophthalmol 124, 149–155 (2012). https://doi.org/10.1007/s10633-012-9314-5
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DOI: https://doi.org/10.1007/s10633-012-9314-5