A Case of Surgically Treated Serous Macular Detachment Associated With Optic Disc Pit

Jung-Wan Ryu; Ho Ra; Won-Ki Lee

doi:10.3341/jkos.2010.51.1.155

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Ryu, Ra, and Lee: A Case of Surgically Treated Serous Macular Detachment Associated With Optic Disc Pit

Original Article

J Korean Ophthalmol Soc 2010;51(1):155-158.

Published online: 7 September 2010

DOI: https://doi.org/10.3341/jkos.2010.51.1.155

A Case of Surgically Treated Serous Macular Detachment Associated With Optic Disc Pit

Jung-Wan Ryu, MD, Ho Ra, MD, Won-Ki Lee, MD

Department of Ophthalmology and Visual Science, College of Medicine, The Catholic University of Korea, Seoul, Korea

Address reprint requests to Won Ki Lee, MD Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, College of Medicine, The Catholic University #505 Banpo-dong, Seocho-gu, Seoul 137-701, Korea Tel:82-2-2258-2846, Fax:82-2-599-7405, E-mail: wklee@catholic.ac.kr

Received 14 October 2008 Accepted 30 September 2009

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To report the clinical results of a planned vitrectomy, laser photocoagulation and gas tamponade for the treatment of serous macular detachment associated with optic disc pit. However, laser photocoagulation was performed on a postoperative outpatient basis for subretinal fluid.

Case summary:

A 13-year-old women presented with central visual disturbance in the left eye. Her best-corrected visual acuity (BCVA) was 0.16. On ophthalmic examination, the patient was diagnosed with optic disc pit combined with serous macular detachment. After 3 months, the serous macular detachment increased and visual acuity decreased to 0.1. Pars plana vitrectomy combined with complete posterior vitreous detachment was performed. After intravitreal injection of perfluorodecalin, internal drainage of the subretinal fluid using the back flush needle around the optic disc pit was performed, but the fluid was not drained. The planned intraoperative photocoagulation was not performed due to a large serous macular detachment. Gas tamponade was performed and a facedown position was maintained for 1 week followed by laser photocoagulation. The subretinal fluid was completely absorbed and visual acuity was improved. In addition, recurrence was not observed throughout the follow-up period.

Keywords: Optic disc pit, Serous macular detachment

References

1. Brown GC, Shields JA, Goldberg RE. Congenital pits of the optic nerve head. II. Clinical studies in humans. Ophthalmology. 1980; 87:51–65.

2. Lincoff H, Schiff W, Krivoy D, Ritch R. Optical coherence tomography of optic disc pit maculopathy. Am J Ophthalmol. 1996; 122:264–6.

3. Rutledge BK, Puliafito CA, Duker JS, et al. Optical coherence aberrations of macular lesions associated with optic nerve head pits. Ophthalmology. 1996; 103:1047–53.

4. García-Arumí J, Guraya BC, Espax AB, et al. Optical coherence tomography in optic pit maculopathy managed with vitrectomy-laser-gas. Graefes Arch Clin Exp Ophthalmol. 2004; 242:819–26.

5. Hirakata A, Okada AA, Hida T. Long-term results of vitrectomy without laser treatment for macular detachment associated with an optic disc pit. Ophthalmology. 2005; 112:1430–5.

6. Yi SH, Lee JH, Chang MH. Laser therapy on macular serous aberrations caused by optic disc pit. J Korean Ophthalmol Soc. 1997; 38:2155–9.

7. Lincoff H, Yannuzzi L, Singerman L, et al. Improvement in visual function after displacement of the retinal elevations emanating from optic pits. Arch Ophthalmol. 1993; 111:1071–9.

8. Todokoro D, Kishi S. Reattachment of retina and retinoschisis in pit macular syndrome by surgically induced vitreous detachment and gas tamponade. Ophthalmic Surg Lasers. 2000; 31:233–5.

9. Akiba J, Kakehashi A, Hikichi T, Trempe CL. Vitreous findings in cases of optic nerve pits and serous macular detachment. Am J Ophthalmol. 1993; 116:38–41.

10. Hirakata A, Hida T, Wakabayashi T, Fukuda M. Unusual aberrations hyaloid strand in a young child with optic disc pit aberrations: Intraoperative and histopathological findings. Jpn J aberrations. 2005; 49:264–6.

11. Theodossiadis PG, Grigoropoulos VG, Emfietzoglou J, aberrations GP. Vitreous findings in optic disc pit maculopathy based on optical coherence tomography. Grafes Arch Clin Exp aberrations. 2007; 245:1311–8.

12. Lee YW, Chung DY, Chung YT. A case of optic disc pit. J Korean Ophthalmol Soc. 1991; 32:683–7.

Figure 1.

A: Preoperative fundus photograph shows an inferotemporal gray optic disc pit and about 3.5 disc diameter-sized serous macular detachment (arrowheads). The arrow points to the direction of optical coherence tomography (OCT) scan. B, C: Preoperative OCT images shows the subretinal fluid in macular detachment (B) and intraretinal schisis connected with optic disc pit (arrow, C). D: At three-month follow-up visit, serous macular detachment increased to about 5 disc diameter. So we planned surgical treatment. E: Two years after vitrectomy, fundus photograph shows no recurrence of serous macular detachment. F, G: Two years after vitrectomy, horizontal and vertical OCT images show no residual subretinal fluid and closed intraretinal schisis connected with optic disc pit.

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