Surgical Options for Optic Disc Pit Maculopathy: Perspectives and Controversies

Abstract

Salvador Pastor-Idoate,1– 3 Claudia García-Arumí Fusté,4,5 Luis García-Onrubia,1 Sergio Copete,6 José García-Arumí3– 5,7,8 1IOBA Eye Institute, University of Valladolid, Valladolid, Spain; 2Clinical University Hospital of Valladolid, Valladolid, Spain; 3Red Temática de Investigación Cooperativa en Salud (RETICS), Oftared, Instituto de Salud Carlos III, Madrid, Spain; 4Vall d´Hebron University Hospital, Barcelona, Spain; 5Ophthalmology Research, Vall d´Hebron Research Institute (VHIR), Barcelona, Spain; 6Complex University Hospital, Albacete, Spain; 7Ocular Microsurgery Institute (IMO), Barcelona, Spain; 8Department of Ophthalmology, Autonomous University of Barcelona, Barcelona, SpainCorrespondence: José García-ArumíVall d´Hebron University Hospital, Passeig De La Vall D’hebron, 119-129, Barcelona 08035, SpainTel [phone]Fax [phone]Email [email protected]: Optic disc pit (ODP) is a rare congenital optic nerve head abnormality, which can be complicated by intraretinal and subretinal fluid at the macula (ODP-maculopathy) with progressive visual loss. The source of this fluid remains unclear and the most dominant hypotheses have pointed to vitreous cavity or cerebrospinal fluid. Although spontaneous resolution has been reported, the majority of untreated cases of ODP-maculopathy result in final visual acuity less than 20/200 or worse. A wide array of interventions, either individually or in combination with adjuvant treatments, have been tried with varying degrees of success. Recently, different surgical procedures to fill the ODP by self-sealing materials in combination with pars plana vitrectomy have been reported as an effective adjuvant treatment. However, given the relative rarity of this condition, the majority of reports describe a small retrospective case series, making it difficult to compare among different treatments options and create a consensus regarding the optimal treatment for ODP-maculopathy. In this situation, a mini-review about surgical treatment modalities and their results can be a useful approach to identify the most effective surgical option in the management of ODP-maculopathy.Keywords: optic disc pit, optic disc pit maculopathy, optic disc pit maculopathy treatments, optic nerve stuffing, post-operative outcomes, pars plana vitrectomy

Keywords

• optic disc pit
• optic disc pit maculopathy
• optic disc pit maculopathy treatments
• optic nerve stuffing
• post-operative outcomes
• pars plana vitrectomy