Multicenter study of pars plana vitrectomy for optic disc pit maculopathy: MACPIT study

Abstract

PurposeTo evaluate surgical intervention with pars plana vitrectomy (PPV) for correction of optic disc pit maculopathy (ODP-M).Patients and methodsRetrospective chart review from 13 centres of 51 eyes of 50 patients with ODP-M who underwent PPV between 2002-2014. Anatomic and final best-corrected visual acuity (BCVA) outcomes were evaluated for all cases with different adjuvant techniques.ResultsThere were 23 males and 27 females with median age 25.5 (6-68) years. Preoperative median foveal thickness was 694.5 (331-1384) μm and improved to 252.5 (153-1405) μm. Median BCVA improved from 20/200 (20/20000 to 20/40) to 20/40 (20/2000 to 20/20) with 20/40 or better in 31 eyes. Complete retinal reattachment was achieved in 44 eyes (86.3%) at 7.1 (5.9) months. The good surgical outcomes were achieved in different adjuvant groups. Median follow-up was 24 (6 to 120) months.ConclusionsThese results confirm the long-term effectiveness of PPV for ODP-M. Prospective studies are needed to determine the effectiveness of any adjuvant technique in improving the success of PPV for ODP-M.

Figure 1

Kaplan–Meier Graph for the time to Complete Resolution of Optic Disc Pit Maculopathy: vertical axis shows proportion of eyes with persistent detachment and the horizontal axis shows the time (in months) to complete resolution from the date of surgery. Complete anatomical success within the first 6 months was seen in ~60% of the study eyes and 25% reattached after month-12.

Figure 2

A 19-year-old male student in the Dentistry Faculty presented with progressive visual deterioration, which had been ongoing for 3 months. (a and b) Fundus examination and OCT revealed ODP maculopathy. Visual acuity was 20/63. Due to university studies, the operation was delayed for 2 months until June 2012. PPV was applied together with juxtapapillary laser photocoagulation (JLP) and 13% C3F8 tamponade. (c) 3 months after the operation, there was little change to the macular thickness and visual acuity was the same. (d) Macular thickness decreased significantly and an outer layer hole developed at 7 months. BCVA was 20/50. (e) Macula was attached at month-12 with collapse of schisis-like intraretinal separation. There was residual intraretinal fluid with interruption of the central ellipsoid zone. BCVA was 20/40. (f and g) Intraretinal fluid gradually disappeared at months 18 and 19. BCVA was 20/32 and 20/25, respectively, at these visits. (h) Fundus photography shows an area of tiny residual subretinal fluid near the optic nerve head. (j and k) Retinal restoration was complete at month 33. BCVA was 20/20. Multicolour photography shows complete attachment with a thin and regular JPL scar. Automated visual field testing showed no related visual field scotoma. Follow-up was 42 months.