Optic disc pit maculopathy – case series, clinical approach, and management
Dimitrios Kalogeropoulos1, Soon Wai Ch'ng2, Rynn Lee2, Ibrahim Elaraoud2, Vinaya Felicida2, Maninee Purohit2, Maggie Mathew3, Naduviledeth Ajith-Kumar2, Ash Sharma2, Arijit Mitra2
1 Department of Ophthalmology, Birmingham and Midland Eye Centre, Birmingham, England, United Kingdom; Department of Ophthalmology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
2 Department of Ophthalmology, Birmingham and Midland Eye Centre, Birmingham, England, United Kingdom
3 Department of Ophthalmology, University Hospitals of Leicester, Leicester Royal Infirmary, Leicester, England, United Kingdom
Dr. Dimitrios Kalogeropoulos
Department of Ophthalmology, Birmingham and Midland Eye Centre, City Hospital NHS Trust, Dudley Road, Birmingham B18 7QH, England
Source of Support: None, Conflict of Interest: None
PURPOSE: The purpose of this study was to analyze the diagnostic and therapeutic approach of five cases with optic disc pit (ODP) maculopathy.
MATERIALS AND METHODS: This was a retrospective study of five patients diagnosed with ODP maculopathy. Four of these cases had unilateral involvement, whereas one case had bilateral findings. The medical notes of these individuals were reviewed in order to record the presenting symptoms, clinical signs, visual acuity (VA), imaging, management, and the final visual outcome on their last follow-up appointment.
RESULTS: The first patient (53-year-old female) underwent a left pars plana vitrectomy (PPV) combined with inner retinal fenestration, endolaser, and perfluoropropane (C3F8) gas tamponade and her VA improved from 6/24 to 6/9 Snellen. A focal retinal laser treatment was carried out on our second patient leading to decrease of the subretinal fluid but had a poor visual outcome due to the underlying secondary glaucoma from iris melanoma treatment in the past. The third patient was an asymptomatic 7-year-old girl in which the maculopathy resolved spontaneously without any surgical intervention with a final VA of 6/5. The fourth and fifth patients were asymptomatic with good vision in both eyes and were, therefore, only monitored with follow-ups.
CONCLUSION: ODP maculopathy remains a challenging clinical entity for a vitreoretinal surgeon. The current management for ODP maculopathy involves surgical procedures with PPV being a common treatment of choice. Spontaneous resolution of ODP maculopathy has also been reported. Our study highlights the contrasting management that can be adopted in the treatment of ODP maculopathy, and there is not one definite treatment for this condition.