Improvement in visual function after displacement of the retinal elevations emanating from optic pits

Abstract

Objective: To define the functional deficit that correlates with the inner layer separation and the outer layer detachment that have been observed in optic pit maculopathy and to determine the effect of a gas tamponade that compresses or displaces the two layers.

Design: The central visual field before and after a gas tamponade on the posterior pole were charted on a 1-m tangent screen and compared with the changes in the retina observed biomicroscopically and with stereophotography.

Setting: The gas operations were done at four hospitals in the New York, NY, area and one in Cleveland, Ohio. The retinal examinations, visual field testing, and stereoscopic photography for eight patients were done at The New York Hospital. The patient who lived in Cleveland was examined and photographed in Cleveland.

Participants: Nine patients between the ages of 18 and 46 years with optic pit maculopathy.

Intervention: The patients were operated on by five retinal surgeons with a variety of procedures. Four patients had a vitrectomy and intraocular gas injected. Five patients had gas injected after external compression. Two patients had laser applied in conjunction with the intraocular injection. The gas tamponade was the unifying factor.

Results: The dense central scotoma in optic pit maculopathy relates to the outer layer detachment and displacement of it from the posterior pole yields an improvement in visual acuity. The inner layer separation persists centrally after a gas tamponade and continues to provide access for the flow of fluid from the pit. The scotoma that relates to the inner layer separation is mild and consistent with relatively good visual acuity.