Treatment outcomes of optic disc pit maculopathy over two decades

Avadhesh Oli; Divya Balakrishnan

doi:10.1177/25158414211027715

Treatment outcomes of optic disc pit maculopathy over two decades

Ther Adv Ophthalmol. 2021 Jun 30:13:25158414211027715. doi: 10.1177/25158414211027715. eCollection 2021 Jan-Dec.

Authors

Avadhesh Oli¹, Divya Balakrishnan²

Affiliations

¹ Smt Kanuri Santhamma Centre of Vitreoretinal diseases, LV Prasad Eye Institute, Kallam Anji Reddy Campus, L. V. Prasad Marg, Banjara Hills, Hyderabad 500034, Telangana, India.
² Smt Kanuri Santhamma Centre of Vitreoretinal diseases, LV Prasad Eye Institute, Hyderabad, India.

Abstract

Aim: To study the long-term outcomes of optic disc pit maculopathy.

Methods: Electronic medical records of 154 patients with optic disc pit were reviewed and 50 patients with optic disc pit maculopathy who met the study criteria were included in the study. Demographic profile of patients, along with clinical characteristics, optical coherence tomography (OCT) features and change in best-corrected visual acuity (BCVA) was recorded. Patients were treated either by observation, barrage laser alone or pars plana vitrectomy (PPV) with optional additional surgical procedures. The primary outcome measures were the change in BCVA and resolution of fluid on OCT.

Results: The mean age of patients was 29.96 years (3-62 years) with a follow-up of 27.16 months. The mean baseline BCVA in observation, laser and vitrectomy group was log MAR 0.94, 0.76 and 0.87 and final BCVA was log MAR 0.9, 0.67 and 0.46, respectively. There was a statistically significant improvement in the final BCVA and reduction in subretinal fluid with resolution of the schisis cavity in vitrectomy group than in other groups. On regression analysis significant association was found between final BCVA with baseline BCVA (R ² = 0.815, p = 0.002), use of C3 F8 endotempanode (p = 0.004) ILM peeling (p = 0.012) and use of triamcinolone (TA; p = 0.003). No significant association was found with juxtapapillary endolaser (p = 0.062).

Conclusions: In patients with disc pit maculopathy, PPV lead to better functional and anatomical outcomes as compared to laser or observation alone. Use of surgical adjuvants like ILM peeling, TA and C3F8 tamponade improved the outcomes, unlike juxtapapillary endolaser treatment.

Keywords: optic disc pit; pit maculopathy; schisis; treatment outcomes; vitrectomy.