Management of optic disc pit maculopathy: the European VitreoRetinal society optic pit study


Iros M., Parolini B., ÖZDEK Ş., Gini G., Michalewska Z., Ellaban A. A., ...Daha Fazla

ACTA OPHTHALMOLOGICA, cilt.100, sa.6, 2022 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 100 Sayı: 6
  • Basım Tarihi: 2022
  • Doi Numarası: 10.1111/aos.15076
  • Dergi Adı: ACTA OPHTHALMOLOGICA
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, L'Année philologique, BIOSIS, EMBASE, MEDLINE
  • Anahtar Kelimeler: gas tamponade, internal limiting membrane peeling, optic disc pit maculopathy, optic nerve pit maculopathy, pars plana vitrectomy, retreatment, COHERENCE TOMOGRAPHY FINDINGS, INTERNAL LIMITING MEMBRANE, INNER RETINAL FENESTRATION, SEROUS MACULAR DETACHMENT, GAS TAMPONADE, NERVE PIT, VITRECTOMY, RETINOSCHISIS, PATHOGENESIS, MORPHOLOGY
  • Gazi Üniversitesi Adresli: Evet

Özet

Purpose To evaluate a variety of techniques, and their anatomical and functional results, for the treatment of optic disc pit maculopathy (ODP-M). A secondary aim was to report on results of secondary procedures in cases of initial failure or recurrence. Methods Multicentre retrospective study of 95 eyes with ODP-M, treated by 25 surgeons from 12 countries. Primary outcomes were anatomical resolution of subretinal fluid (SRF), intraretinal fluid (IRF) and visual acuity (VA) at 12 months. Results Higher rates of SRF and IRF resorption were achieved in eyes treated with pars plana vitrectomy (PPV) compared to external laser with or without tamponade: 64/72 (88.9%) versus 8/14 (57.1%) for SRF (p = 0.003), and 50/59 (84.7%) versus 3/10 (30%) for IRF (p = 0.002). The addition of juxtapapillary laser or internal limiting membrane (ILM) peel during PPV did not improve SRF or IRF resolution. Pars plana vitrectomy (PPV) with tamponade and PPV with tamponade plus endolaser were associated with significant visual gain. In the former group, VA improved from a mean of logMAR 0.91 (20/162), to a mean of logMAR 0.52 (20/66) at 12 months; in the latter group, VA improved from a mean of logMAR 0.82 (20/132) to a mean of logMAR 0.47 (20/59) at 12 months. Retreatments were performed in 14 eyes (15.7%), only enhancing anatomical outcomes. Conclusion Vitrectomy with tamponade had better final outcomes than external laser treatment with or without gas tamponade. Laser endophotocoagulation and ILM peel provided no additional benefit. A secondary treatment resulted in anatomical but not functional improvement.