A Patient With Optic Nerve Pit Maculopathy Successfully Treated With Juxtapapillary Laser Photocoagulation
Abstract
Optic disc pits are rare and congenital or acquired anomalies of the optic disc, usually remaining asymptomatic. However, serous macular detachment or optic disc maculopathy is the most common complication, causing significant visual deterioration, without a current consensus about treatment. A 55-year-old woman with a past medical history of diabetes mellitus and systemic hypertension was referred for an abnormal finding in the retina. The Corrected Distance Visual Acuity (CDVA) was 20/40 in the right eye and 20/30 in the left eye. Marcus-Gunn was negative and Slit-lamp biomicroscopy revealed no pathologic findings in both eyes. Funduscopic examination showed an excavation in the inferotemporal part of the Optic Nerve Head (ONH) with serous macular detachment extending to the optic disc. Based on clinical examination and paraclinical imaging fluorescein Angiogeraphy (FAG) Optical Coherence Tomography (OCT), optic pit maculopathy was diagnosed and the patient underwent Juxtapapillary Laser Photocoagulation (JLP). After 2 years of follow-up, there were anatomical and functional improvements.
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[8] Zheng A, Singh RP, Lavine JA. Surgical options and outcomes in the treatment of optic pit maculopathy: َ meta-analysis and systematic review. Ophthalmology Retina. 2020; 4(3):289-99. [DOI:10.1016/j. oret.2019.10.011] [PMID]
[9] Theodossiadis G. Evolution of congenital pit of the optic disk with macular detachment in photocoagulated and nonphotocoagulated eyes. American Journal of Ophthalmology. 1977; 84(5):620-31. [DOI:10.1016/0002-9394(77)90375-0] [PMID]
[10] Theodossiadis GP, Theodossiadis PG, Ladas ID, Zafirakis PK, Kol- lia AC, Koutsandrea C, et al. Cyst formation in optic disc pit mac- ulopathy. Documenta Ophthalmologica. 1999; 97(3-4):329-35. [DOI:10.1023/A:1002194324791] [PMID]
[11] Ferry AP. Macular detachment associated with congenital pit of the optic nerve head: Pathologic findings in two cases simulating malig- nant melanoma of the choroid. Archives of Ophthalmology. 1963; 70(3):346-57. [DOI:10.1001/archopht.1963.00960050348014] [PMID]
[12] Dithmar S, Schuett F, Voelcker HE, Holz FG. Delayed sequential occurrence of perfluorodecalin and silicone oil in the subretinal space following retinal detachment surgery in the presence of an optic disc pit. Archives of Ophthalmology. 2004; 122(3):409-11. [DOI:10.1001/archopht.122.3.409] [PMID]
[13] Salam A, Khan-Lim D, Luff AJ. Superior retinal detachment in an oil- filled eye with a colobomatous optic disc. Retinal Cases and Brief Re- ports. 2008; 2(2):124-5. [DOI:10.1097/ICB.0b013e3180338f0f] [PMID]
[14] Coll GE, Chang S, Flynn TE, Brown GC. Communication between the subretinal space and the vitreous cavity in the morning glory syndrome. Graefe’s Archive for Clinical and Experimental Ophthal- mology. 1995; 233(7):441-3. [DOI:10.1007/BF00180949] [PMID]
[15] Krivoy D, Gentile R, Liebmann JM, Stegman Z, Rosen R, Walsh JB, et al. Imaging congenital optic disc pits and associ- ated maculopathy using optical coherence tomography. Ar- chives of Ophthalmology. 1996; 114(2):165-70. [DOI:10.1001/ar- chopht.1996.01100130159008] [PMID]
[16] Rutledge BK, Puliafito CA, Duker JS, Hee MR, Cox MS. Optical co- herence tomography of macular lesions associated with optic nerve head pits. Ophthalmology. 1996; 103(7):1047-53. [DOI:10.1016/ S0161-6420(96)30568-X] [PMID]
[17] Ohno-Matsui K, Hirakata A, Inoue M, Akiba M, Ishibashi T. Evalu- ation of congenital optic disc pits and optic disc colobomas by swept-source optical coherence tomography. Investigative Oph- thalmology & Visual Science. 2013; 54(12):7769-78. [DOI:10.1167/ iovs.13-12901] [PMID]
[18] Irvine AR, Crawford JB, Sullivan JH. The pathogenesis of retinal de- tachment with morning glory disc and optic pit. Transactions of the American Ophthalmological Society. 1986; 84:280-92. [PMID] [PMCID]
[19] Kuhn F, Kover F, Szabo I, Mester V. Intracranial migration of silicone oil from an eye with optic pit. Graefe’s Archive for Clinical and Ex- perimental Ophthalmology. 2006; 244(10):1360-2. [DOI:10.1007/ s00417-006-0267-9] [PMID]
[20] Chang S, Haik BG, Ellsworth RM, Louis LS, Berrocal JA. Treat- ment of total retinal detachment in morning glory syndrome. American Journal of Ophthalmology. 1984; 97(5):596-600. [DOI:10.1016/0002-9394(84)90379-9] [PMID]
[21] Kalina RE, Conrad WC. Intrathecal fluorescein for serous macu- lar detachment. Archives of Ophthalmology. 1976; 94(8):1421. [DOI:10.1001/archopht.1976.03910040289024] [PMID]
[22] Wise GN, Dollery CT, Henkind P. The retinal circulation. New York: Harper & Row; 1971. https://www.worldcat.org/title/retinal-circu- lation/oclc/603898905
[23] de Oliveira PRC, Berger AR, Chow DR. Use of evicel fibrin sealant in optic disc pit-associated macular detachment. Oph- thalmic Surgery, Lasers & Imaging Retina. 2017; 48(4):358-63. [DOI:10.3928/23258160-20170329-13] [PMID]
[24] Nadal J, Figueroa MS, Carreras E, Pujol P, Canut MI, Barraquer RI. Autologous platelet concentrate in surgery for macular detachment associated with congenital optic disc pit. Clinical Ophthalmology. 2015; 9:1965-71. [DOI:10.2147/OPTH.S81976] [PMID] [PMCID]
[25] Bottoni F, Cereda M, Secondi R, Bochicchio S, Staurenghi G. Vitrec- tomy for optic disc pit maculopathy: A long-term follow-up study. Graefe’s Archive for Clinical and Experimental Ophthalmology. 2018; 256(4):675-82. [DOI:10.1007/s00417-018-3925-9] [PMID]
[26] Karacorlu M, Muslubas IS, Hocaoglu M, Ozdemir H, Arf S, Uysal O. Long-term outcomes of radial optic neurotomy for manage- ment of optic disk pit maculopathy. Retina. 2016; 36(12):2419-27. [DOI:10.1097/IAE.0000000000001101] [PMID]
[27] Ooto S, Mittra RA, Ridley ME, Spaide RF. Vitrectomy with inner retinal fenestration for optic disc pit maculopathy. Ophthalmology. 2014; 121(9):1727-33. [DOI:10.1016/j.ophtha.2014.04.006] [PMID]
[28] Theodossiadis GP, Theodossiadis PG. The macular buck- ling technique in the treatment of optic disk pit macu- lopathy. Seminars in Ophthalmology. 2000; 15(2):108-15. [DOI:10.3109/08820530009040001] [PMID]
[29] Brockhurst RJ. Optic pits and posterior retinal detachment. Trans- actions of the American Ophthalmological Society. 1975; 73:264-91. [PMID] [PMCID]
[2] Gass JDM. Serous detachment of the macula: Secondary to congen- ital pit of the optic nervehead. American Journal of Ophthalmology. 1969; 67(6):821-41. [DOI:10.1016/0002-9394(69)90075-0] [PMID]
[3] Sobol WM, Blodi CF, Folk JC, Weingeist TA. Long-term visual out- come in patients with optic nerve pit and serous retinal detach- ment of the macula. Ophthalmology. 1990; 97(11):1539-42. [DOI:10.1016/S0161-6420(90)32380-1] [PMID]
[4] Wiethe T. Ein fall von angeborener deformitat der sehnerven- papille. Arch Augenheilkd. 1882; 11:14-9. https://ci.nii.ac.jp/ naid/10011032491/
[5] Lincoff H, Yannuzzi L, Singerman L, Kreissig I, Fisher Y. Improvement in visual function after displacement of the retinal elevations emanat- ing from optic pits. Archives of Ophthalmology. 1993; 111(8):1071-9. [DOI:10.1001/archopht.1993.01090080067020] [PMID]
[6] Akiyama H, Shimoda Y, Fukuchi M, Kashima T, Mayuzumi H, Shi- nohara Y, et al. Intravitreal gas injection without vitrectomy for macular detachment associated with an optic disk pit. Retina. 2014; 34(2):222-7. [DOI:10.1097/IAE.0b013e3182993d93] [PMID]
[7] Lei L, Li T, Ding X, Ma W, Zhu X, Atik A, et al. Gas tamponade com- bined with laser photocoagulation therapy for congenital optic disc pit maculopathy. Eye. 2015; 29(1):106-14. [DOI:10.1038/ eye.2014.245] [PMID] [PMCID]
[8] Zheng A, Singh RP, Lavine JA. Surgical options and outcomes in the treatment of optic pit maculopathy: َ meta-analysis and systematic review. Ophthalmology Retina. 2020; 4(3):289-99. [DOI:10.1016/j. oret.2019.10.011] [PMID]
[9] Theodossiadis G. Evolution of congenital pit of the optic disk with macular detachment in photocoagulated and nonphotocoagulated eyes. American Journal of Ophthalmology. 1977; 84(5):620-31. [DOI:10.1016/0002-9394(77)90375-0] [PMID]
[10] Theodossiadis GP, Theodossiadis PG, Ladas ID, Zafirakis PK, Kol- lia AC, Koutsandrea C, et al. Cyst formation in optic disc pit mac- ulopathy. Documenta Ophthalmologica. 1999; 97(3-4):329-35. [DOI:10.1023/A:1002194324791] [PMID]
[11] Ferry AP. Macular detachment associated with congenital pit of the optic nerve head: Pathologic findings in two cases simulating malig- nant melanoma of the choroid. Archives of Ophthalmology. 1963; 70(3):346-57. [DOI:10.1001/archopht.1963.00960050348014] [PMID]
[12] Dithmar S, Schuett F, Voelcker HE, Holz FG. Delayed sequential occurrence of perfluorodecalin and silicone oil in the subretinal space following retinal detachment surgery in the presence of an optic disc pit. Archives of Ophthalmology. 2004; 122(3):409-11. [DOI:10.1001/archopht.122.3.409] [PMID]
[13] Salam A, Khan-Lim D, Luff AJ. Superior retinal detachment in an oil- filled eye with a colobomatous optic disc. Retinal Cases and Brief Re- ports. 2008; 2(2):124-5. [DOI:10.1097/ICB.0b013e3180338f0f] [PMID]
[14] Coll GE, Chang S, Flynn TE, Brown GC. Communication between the subretinal space and the vitreous cavity in the morning glory syndrome. Graefe’s Archive for Clinical and Experimental Ophthal- mology. 1995; 233(7):441-3. [DOI:10.1007/BF00180949] [PMID]
[15] Krivoy D, Gentile R, Liebmann JM, Stegman Z, Rosen R, Walsh JB, et al. Imaging congenital optic disc pits and associ- ated maculopathy using optical coherence tomography. Ar- chives of Ophthalmology. 1996; 114(2):165-70. [DOI:10.1001/ar- chopht.1996.01100130159008] [PMID]
[16] Rutledge BK, Puliafito CA, Duker JS, Hee MR, Cox MS. Optical co- herence tomography of macular lesions associated with optic nerve head pits. Ophthalmology. 1996; 103(7):1047-53. [DOI:10.1016/ S0161-6420(96)30568-X] [PMID]
[17] Ohno-Matsui K, Hirakata A, Inoue M, Akiba M, Ishibashi T. Evalu- ation of congenital optic disc pits and optic disc colobomas by swept-source optical coherence tomography. Investigative Oph- thalmology & Visual Science. 2013; 54(12):7769-78. [DOI:10.1167/ iovs.13-12901] [PMID]
[18] Irvine AR, Crawford JB, Sullivan JH. The pathogenesis of retinal de- tachment with morning glory disc and optic pit. Transactions of the American Ophthalmological Society. 1986; 84:280-92. [PMID] [PMCID]
[19] Kuhn F, Kover F, Szabo I, Mester V. Intracranial migration of silicone oil from an eye with optic pit. Graefe’s Archive for Clinical and Ex- perimental Ophthalmology. 2006; 244(10):1360-2. [DOI:10.1007/ s00417-006-0267-9] [PMID]
[20] Chang S, Haik BG, Ellsworth RM, Louis LS, Berrocal JA. Treat- ment of total retinal detachment in morning glory syndrome. American Journal of Ophthalmology. 1984; 97(5):596-600. [DOI:10.1016/0002-9394(84)90379-9] [PMID]
[21] Kalina RE, Conrad WC. Intrathecal fluorescein for serous macu- lar detachment. Archives of Ophthalmology. 1976; 94(8):1421. [DOI:10.1001/archopht.1976.03910040289024] [PMID]
[22] Wise GN, Dollery CT, Henkind P. The retinal circulation. New York: Harper & Row; 1971. https://www.worldcat.org/title/retinal-circu- lation/oclc/603898905
[23] de Oliveira PRC, Berger AR, Chow DR. Use of evicel fibrin sealant in optic disc pit-associated macular detachment. Oph- thalmic Surgery, Lasers & Imaging Retina. 2017; 48(4):358-63. [DOI:10.3928/23258160-20170329-13] [PMID]
[24] Nadal J, Figueroa MS, Carreras E, Pujol P, Canut MI, Barraquer RI. Autologous platelet concentrate in surgery for macular detachment associated with congenital optic disc pit. Clinical Ophthalmology. 2015; 9:1965-71. [DOI:10.2147/OPTH.S81976] [PMID] [PMCID]
[25] Bottoni F, Cereda M, Secondi R, Bochicchio S, Staurenghi G. Vitrec- tomy for optic disc pit maculopathy: A long-term follow-up study. Graefe’s Archive for Clinical and Experimental Ophthalmology. 2018; 256(4):675-82. [DOI:10.1007/s00417-018-3925-9] [PMID]
[26] Karacorlu M, Muslubas IS, Hocaoglu M, Ozdemir H, Arf S, Uysal O. Long-term outcomes of radial optic neurotomy for manage- ment of optic disk pit maculopathy. Retina. 2016; 36(12):2419-27. [DOI:10.1097/IAE.0000000000001101] [PMID]
[27] Ooto S, Mittra RA, Ridley ME, Spaide RF. Vitrectomy with inner retinal fenestration for optic disc pit maculopathy. Ophthalmology. 2014; 121(9):1727-33. [DOI:10.1016/j.ophtha.2014.04.006] [PMID]
[28] Theodossiadis GP, Theodossiadis PG. The macular buck- ling technique in the treatment of optic disk pit macu- lopathy. Seminars in Ophthalmology. 2000; 15(2):108-15. [DOI:10.3109/08820530009040001] [PMID]
[29] Brockhurst RJ. Optic pits and posterior retinal detachment. Trans- actions of the American Ophthalmological Society. 1975; 73:264-91. [PMID] [PMCID]
| Files | ||
| Issue | Vol 6 No 4 (2021): July-August | |
| Section | Case Report(s) | |
| DOI | https://doi.org/10.18502/crcp.v6i4.7856 | |
| Keywords | ||
| Congenital anomaly Optic disc pit Maculopathy Laser therapy | ||
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How to Cite
1.
Nikkhah H, Ansari I, Hassanpour K. A Patient With Optic Nerve Pit Maculopathy Successfully Treated With Juxtapapillary Laser Photocoagulation. CRCP. 2021;6(4):155-159.
