Autologous Internal Limiting Membrane Flap Techniques for Optic Disc Pit Maculopathy: Optical Coherence Tomography Imaging Findings and Surgical Approach: Case Series

Abstract

Purpose : To evaluate the translocation and transplantation of inverted autologous internal limiting membrane (ILM) flap techniques for the treatment of chronic, and/or refractory optic disc pit (ODP) maculopathy and how Swept-source optical coherence tomography (SS-OCT) provides enhanced diagnostic information enabling optimization of surgical strategy in patients suffering from ODP maculopathy.

Methods : 6-month prospective interventional case series.
5 eyes of 5 patients with ODP maculopathy underwent pars plana vitrectomy (PPV) and ILM peeling followed by positioning of the ILM remnant to cover the optic disc pit. Fluid–air exchange and gas tamponade were then performed. OCT and clinical examinations were performed before surgery and postoperatively at 1 week and 1, 3 and 6 months.

Results : Preoperative foveal thickness mean was 771.60 (range: 366 µm to 1151 µm). Satisfactory postoperative maculopathy thickness reduction was observed in all cases. Postoperative foveal thickness mean 6 month after surgery was 472.80 (range: 210 µm to 832 µm) (p<0.05). Preoperative visual acuity mean was 20/60 (range: 20/400 to 20/30). Mean postoperative visual acuity 6 month after surgery was 20/40 (range: 20/60 to 20/25) (p=0.02). The presence of postoperative ILM flap as hyperreflective line at the base of the optic nerve excavation was seen in all cases.

Conclusions : Treatment with autologous ILM flap techniques could be alternative treatments for chronic and/or refractory ODP maculopathy in our case series. SS-OCT improved the visualization of cortical vitreous, highlighted the position of the inverted flap and could assist in the choice of surgical technique comparing to SD-OCT.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.