Purchase this article with an account.
G. Iribarren, P. Holzman, M. Valeiras, R. Iribarren, J. Badia; Vitrectomy and Air/Fluid Exchange Without Laser Treatment for Serous Macular Detachment Associated With Optic Disc Pits . Invest. Ophthalmol. Vis. Sci. 2006;47(13):5262.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To present the follow up of two patients with serous detachment of the macula associated with optic disc pits treated with vitrectomy , detachment of the posterior hyaloid, intraocular gas tamponade ( C3F8) and face down positioning without laser treatment
The two patients received complete ocular examination, including best corrected visual acuity, Slit lamp examination of the anterior segment, intraocular pressure, fundus examination with contact lenses and indirect ophthalmoscopy, fundus photography, angiography and OCT. Case 1 : 21 y/o white male . VA: OD: sph –200: C/F, OS: sph –1.75 : 20/20 , IOP: 16 mmHg OU: Fundus: OD:macular detachment associated with optic disc pit. OS: retinal coloboma inferior to the optic disc.
Case 2: 29 y/o white male. VA: OD: cyl –0.50 x 90º : 20/30, OS: sph. +1.25 : 20/200. IOP: 17mmHg OU, Fundus: OD: normal fundus, OS :Fundus appearence was that of a Morning Glory syndrome but the OCT showed the typical comunication between de optic nerve and the serous macular detachment of the optic disc pit.
They were operated on with standard 21G three port vitrectomy, detachment of the posterior hyaloid, intraocular gas tamponade with 18% C3F8 and face down position for 2 weeks.After de first month the patients were followed up every two months for the first six months and every three months up to the first year.
In both cases the subretinal fluid was displaced inferiorly after surgery and slowly reabsorbed during the following months. By the end of the first year both cases showed complete reattachment of the macula with no subretinal fluid on the OCT.
Final VA: Case 1: OD: sph. –2.5 cyl. 0.50 x 40° 20/100 OS: sph. –2.00: 20/20 Case 2: OD: cyl –0.50 x 90: 20/30 OS: cyl –0.75 x 120º: 20/40.
Although most of the papers usually recommend vitrectomy , endolaser around the disc and gas injection, we were able in this two cases to reattach the retina without laser treatment in an attempt to avoid lesion of the papilomacular bundle. Both cases had an improvement of their visual acuity and a follow up of one year. There should be more cases enrolled to determine if this technique is good enough to maintain the retina attached and can improve visual outcome.
This PDF is available to Subscribers Only