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Tadashi Yokoi, Sachiko Nishina, Noriyuki Azuma; Premacular Vitreous Pocket and Traction of the Vitreous Trigger the Maculopathy Associated with Optic Disc Pit. Invest. Ophthalmol. Vis. Sci. 2014;55(13):1113.
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© ARVO (1962-2015); The Authors (2016-present)
Maculopathy associated with optic disc pits (ODP), sometimes causes severe visual loss, usually appears in late childhood or early adulthood. However, it has long been unclear how the disease begins to develop from those ages.We evaluated the relationship between vitreous structure and maculopathy associated with ODP.
Methods: Six patients (7 eyes) with ODP was diagnosed between July 1990 and May 2013. Fundus photographs and swept-source optical coherence tomography (SS-OCT) images were evaluated retrospectively, and the vitreous at the vitreoretinal interface was visualized by reconstructing three-dimensional SS-OCT images. Vitrectomy was performed in the eyes with maculopathy.
Results: In six patients (7 eyes) with OPD, five patients had unilateral disease and one patient was affected bilaterally. The pits were mainly located temporally, and maculopathy, including retinoschisis and retinal detachment, was detected in five eyes associated only with the temporal pits. A flat retinal detachment was observed in four eyes and identified within the vascular arcade except in one eye. A premacular vitreous pocket was observed in all eyes except for one eye without maculopathy. Reconstructing images from SS-OCT clarified the vitreoretinal interface abnormalities around the optic disc and inner arcade area in all eyes. Vitrectomy was performed in four eyes with a retinal detachment to resect the abnormal vitreous traction. A posterior vitreous detachment was created in two eyes. Retinal reattachment was achieved in three eyes, and subretinal fluid receded in one eye. The visual acuity improved in all four eyes.
Conclusion: Development of a PVP and strengthening traction on the vitreous due to a congenital abnormality of the vitreoretinal interface may generate the maculopathy associated with ODPs.
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