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Abstract
Purpose
To report a long term result of vitrectomy, gas tamponade without laser retinopexy for serous macular detachment associated with an optic disc pit (ODP).
Case summary
A 13 year old boy with visual disturbance in the left eye showed serous macular detachment associated with an inferior temporal ODP. The abnormal vitreous strand over the optic disc implying vitreous traction and retinoschisis were revealed by the optical coherence tomography (OCT) examination. Pars plana vitrectomy after complete induction of posterior vitreous detachment without laser retinopexy, and gas tamponade with postoperative facedown positioning were performed. Complete retinal attachment occurred at 6 months after first operation but recurrent macula detachment occurred at 15 months after first operation. Additional gas tamponade resulted in successful retinal attachment for more than 2 years and visual improvement.
Conclusions
Vitrectomy and gas tamponade without additional laser photocoagulation could be another option for the treatment of ODP maculopathy. But recurrent macular detachment might occur and simple gas tamponade was effective in this case. This result supports another factor in addition to vitreous traction may play a role in the development of the macular detachment associated ODP. Further studies are required to evaluate the effect of vitrectomy, gas tamponade without laser retinopexy for the treatment of ODP maculopathy.
References
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Figure 1.
(A) Preoperative fundus photograph of the left eye showing inferotemporal optic disc pit associated serous macular detachment. (B) Late phase of the fluorescein angiography showing hypofluorescence of the optic disc pit and dye pooling into sub-retinal fluid. (C, D) Optical coherence tomography image showing serous macular detachment, schisis-like separation of the retinal layers and dense vitreous strands (white arrow) attached to the optic disc pit.
Figure 2.
(A) Optical coherence tomography (OCT) image showing macular attachment but residual subretinal fluid inferior to the macula. (B) OCT image showing complete resorption of subretinal fluid at 6 months after first operation and (C) re-accumulation of subretinal fluid in the papillomacular area at 15 months after first operation.
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