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Y. Terada, I. Takasu, S. Yumiyama, H. Ohtsuki; Vitreous structure with using Triamcinolone Acetonide in case of optic disc pit maculopathy. . Invest. Ophthalmol. Vis. Sci. 2004;45(13):2000.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To report anomalous finding of vitreous structure intra–surgically in case of optic disc pit maculopathy. Case: A 27–year–old male who had blurred vision in his left eye for months visited our clinic. Ophthalmoscopic examination, fluorescein angiogram and optical coherence tomography (OCT) showed retinoschisis and retinal detachment associated with optic disc pit in posterior pole in his left eye. The vision OS deteriorated to 0.6. The pit was 1/4 disc–diameter in size and situated in the lower temporal quadrant of the normal sized disc. The pit was filled with gray tissue, but microscopic examination before surgery could not reveal a plicated membrane or an overlying membrane clearly. The retinal detachment extended over posterior pole, therefore pars plana vitrectomy underwent after getting an informed consent. In vitrectomy, Triamcinolone Acetonide (TA) was used to visualize vitreous better and not to leave any residual cortex or epiretinal membrane. TA particles could show three chambers of avitreous space that probably meant anterior hyroidean vitreous (HV), posterior HV and preretinal pocket of posterior hyaloid cortex. Also a duct–like structure, which connected with deep inside of the pit, was revealed by TA. After artificial posterior vitreous detachment was made, the duct–like structure still connected with the pit, which was hard to be pulled off with forceps, and residual vitreous membrane was left on macula. Expansive gas injection was performed following fluid–air exchange. One month after the surgery, retinoschisis and retinal detachment dissolved, and visual acuity improved to 1.2. Conclusions: Triamcinolone Acetonide was effective to visualize anomalous vitreous structure in case of optic pit maculopathy. It was found that optic disc pit in this case was intermediated with vitreous space by a duct–like structure. The duct–like structure might be a true duct by which vitreous fluid could flow inside retina.
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