Long-term results of vitrectomy without laser treatment for macular detachment associated with an optic disc pit

Abstract

Purpose: To evaluate the efficacy of vitrectomy and gas tamponade, without laser photocoagulation to the margin of the optic nerve, for the treatment of macular detachment associated with an optic disc pit.

Design: Noncomparative interventional case series.

Participants: Eleven consecutive patients (8-47 years of age) who presented with unilateral macular detachment associated with an optic disc pit.

Intervention: Pars plana vitrectomy, induction of posterior vitreous detachment (PVD), and gas tamponade were performed, with postoperative facedown positioning for 1 week. The presence of a double-layer detachment consisting of an inner layer separation and an outer layer detachment was observed in 10 of 11 eyes either preoperatively or postoperatively. Patients were observed for 10 to 98 months (mean, 47) after surgery.

Main outcome measures: Anatomic outcome and visual acuity were retrospectively analyzed for all eyes. Optical coherence tomography was used to observe anatomic changes in the macula in some eyes.

Results: Complete retinal reattachment was achieved in 10 of 11 eyes, although these eyes required nearly 1 year to reach this state. The one eye with persistent retinal detachment was observed to have a marked reduction of the detachment by 10 months postoperatively. No recurrences were observed. Visual acuity improvement was documented in 7 of 11 eyes.

Conclusions: These results suggest that vitrectomy with induction of PVD and gas tamponade, without additional laser treatment, is successful in reattaching the macula and improving central vision in most patients with optic disc pit maculopathy.