April 2011
Volume 52, Issue 14
Free
ARVO Annual Meeting Abstract  |   April 2011
Post-surgical Repair Of Macular Detachment Associated With An Optic Disc Pit: Spectral Domain-optical Coherence Tomography Evaluation
Author Affiliations & Notes
  • Roberta Secondi
    Dpt of Clinical Science, Eye Clinic Sacco Hospital, Milan, Italy
  • Ferdinando Bottoni
    Dpt of Clinical Science, Eye Clinic Sacco Hospital, Milan, Italy
  • Giovanni Staurenghi
    Dpt of Clinical Science, Eye Clinic Sacco Hospital, Milan, Italy
  • Footnotes
    Commercial Relationships  Roberta Secondi, None; Ferdinando Bottoni, None; Giovanni Staurenghi, Heidelberg Engineering (C)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science April 2011, Vol.52, 6108. doi:
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      Roberta Secondi, Ferdinando Bottoni, Giovanni Staurenghi; Post-surgical Repair Of Macular Detachment Associated With An Optic Disc Pit: Spectral Domain-optical Coherence Tomography Evaluation. Invest. Ophthalmol. Vis. Sci. 2011;52(14):6108.

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Abstract

Purpose: : To evaluate the ultrastructural changes in the macula using spectral domain optical coherence tomography (SD-OCT) in eyes with optic disk pit (ODP) associated maculopathy after vitrectomy and gas tamponade.

Methods: : 4 eyes of 4 consecutive patients with ODP and serous macular detachment underwent pars plana vitrectomy, induction of posterior vitreous detachment (PVD) with posterior hyaloid dissection,,fluid/air exchange and 20% SF6 gas tamponade. SD-OCT images (Spectralis HRA+OCT, Heidelberg Engineering, Heidelberg, Germany) were obtained before surgery (baseline), 1 month after and then every 3 months during follow-up. Each examination included also fundus autofluorescence imaging and best-corrected visual acuity (BCVA). Mean duration of postoperative follow-up was 12 months (range 6-18 months).

Results: : The presence of a double-layer detachment consisting in a schisis-like inner and outer retinal layers separation and a macular neurosensory detachment was observed in all the eyes preoperatively. Postoperative SD-OCT showed first the progressive reabsorption of the intraretinal fluid with disappearance of the schisis at the level of the inner and outer nuclear layers. The re-establishment of the macular structural integrity preceded the progressive reabsorption of the sub-retinal fluid which lasted for longer time and was nearly achieved in two eyes after an average of 7.5 months post-surgery. OCT showed a progressive thickening of the photoreceptor outer segments in the other two eyes with persistent although decreasing subretinal fluid. BCVA increased progressively with the reabsorption of intra and subretinal fluid. No recurrence was observed in any eyes.

Conclusions: : The SD-OCT images in eyes with ODP maculopathy reflect the changes in the inner and outer retinal layers corresponding with the stage of recovery of the desease: the schisis-like areas recover first, the macular neurosensory detachment recovers more gradually after surgery. The postoperative visual acuity increases accordingly. The thickening of the photoreceptor outer segments suggests a preserved function of the outer retina despite the presence of persistent subretinal fluid.

Keywords: vitreoretinal surgery • macula/fovea • imaging/image analysis: clinical 
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