Optic disc pit maculopathy: tamponade of maculoschisis

Robert E Morris,1–3 Hannah Hashimi,4 Andrew J McFarland,1,2,5 Ferenc Kuhn,2,6–7 Mathew Sapp,1–3 Matthew Oltmanns1–3 1Retina Specialists of Alabama, Birmingham, AL, USA; 2Helen Keller Foundation for Research and Educ...

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Autores principales:	Morris RE, Hashimi H, McFarland AJ, Kuhn F, Sapp M, Oltmanns M
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2019
Materias:	Optic disc pit ODP schisis maculoschisis ODP maculopathy vitrectomy tamponade optical coherence tomography OCT Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/e2eee6b3c1fb4e9e9307330006f398f7
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spelling	oai:doaj.org-article:e2eee6b3c1fb4e9e9307330006f398f72021-12-02T02:28:46ZOptic disc pit maculopathy: tamponade of maculoschisis1177-5483https://doaj.org/article/e2eee6b3c1fb4e9e9307330006f398f72019-09-01T00:00:00Zhttps://www.dovepress.com/optic-disc-pit-maculopathy-tamponade-of-maculoschisis-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Robert E Morris,1–3 Hannah Hashimi,4 Andrew J McFarland,1,2,5 Ferenc Kuhn,2,6–7 Mathew Sapp,1–3 Matthew Oltmanns1–3 1Retina Specialists of Alabama, Birmingham, AL, USA; 2Helen Keller Foundation for Research and Education, Birmingham, AL, USA; 3Department of Ophthalmology, University of Alabama at Birmingham (UAB), Birmingham, AL, USA; 4School of Medicine, UAB, Birmingham, AL, USA; 5Retina Associates, Winchester, VA, USA; 6Milos Eye Hospital, Belgrade, Serbia; 7Zagorskeigo Eye Hospital, Krakow, PolandCorrespondence: Robert E MorrisRetina Specialists of Alabama, 2208 University Blvd, Birmingham, AL 35233, USATel +1 205 558 2598Fax +1 205 558 2596Email rmorris@retinanetwork.comPurpose: To present rapid and safe closure of the pit-macula communication (PMC) by core vitrectomy and adequate duration gas tamponade as our preferred method of resolving optic disc pit (ODP) maculopathy and to define the term “maculoschisis” in ODP maculopathy as an alternative to the term “schisis-like.&#x201DPatient and methods: A twenty-four-year-old female presented with an optical coherence tomography (OCT) confirmed ODP and a “giant” communicating maculoschisis cavity. Central macular thickness (CMT) measured 906 microns, and macular volume was twice normal, at 20.8 mm3. Snellen corrected visual acuity was 20/70. Two months after initial vitrectomy performed elsewhere with short-term gas tamponade (SF6 20%), CMT and visual acuity were not significantly improved. Combined lens extraction/intraocular lens placement and repeat vitrectomy with C3F8 15% gas tamponade were performed, with one supplemental (office) gas injection.Results: OCT imaging six weeks postoperatively showed definitive closure of the PMC with CMT reduced by 405 microns. Sequestered from its ODP source, foveal schisis fluid then resolved by 12 weeks postoperatively. At final follow-up 3.4 years postoperatively, the macula remained dry with a CMT of 322 microns and a concave foveal contour. Macular volume was reduced to (a normal) 10.2 mm3 and visual acuity had improved to 20/25.Conclusion: No report heretofore has documented rapid, sustained closure of the PMC by gas tamponade as the preferred method of expeditiously resolving ODP maculopathy. However, tamponade PMC closure sequesters ODP fluid and uniquely provides early assurance of ultimate maculopathy resolution. In all other techniques, PMC closure is a trailing phenomenon and success remains uncertain during months to a year or more of (unsequestered) fluid resolution. We suggest that more invasive techniques (laser barrier application to the peripapillary choroid, vitreoretinal interface maneuvers, and pit-plugging) be withheld unless a recurrence is detected during subsequent examinations.Keywords: optic disc pit, ODP, schisis, maculoschisis, ODP maculopathy, vitrectomy, tamponade, optical coherence tomography, OCT  Morris REHashimi HMcFarland AJKuhn FSapp MOltmanns MDove Medical PressarticleOptic disc pitODPschisismaculoschisisODP maculopathyvitrectomytamponadeoptical coherence tomographyOCTOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 13, Pp 1735-1741 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	Optic disc pit ODP schisis maculoschisis ODP maculopathy vitrectomy tamponade optical coherence tomography OCT Ophthalmology RE1-994
spellingShingle	Optic disc pit ODP schisis maculoschisis ODP maculopathy vitrectomy tamponade optical coherence tomography OCT Ophthalmology RE1-994 Morris RE Hashimi H McFarland AJ Kuhn F Sapp M Oltmanns M Optic disc pit maculopathy: tamponade of maculoschisis
description	Robert E Morris,1–3 Hannah Hashimi,4 Andrew J McFarland,1,2,5 Ferenc Kuhn,2,6–7 Mathew Sapp,1–3 Matthew Oltmanns1–3 1Retina Specialists of Alabama, Birmingham, AL, USA; 2Helen Keller Foundation for Research and Education, Birmingham, AL, USA; 3Department of Ophthalmology, University of Alabama at Birmingham (UAB), Birmingham, AL, USA; 4School of Medicine, UAB, Birmingham, AL, USA; 5Retina Associates, Winchester, VA, USA; 6Milos Eye Hospital, Belgrade, Serbia; 7Zagorskeigo Eye Hospital, Krakow, PolandCorrespondence: Robert E MorrisRetina Specialists of Alabama, 2208 University Blvd, Birmingham, AL 35233, USATel +1 205 558 2598Fax +1 205 558 2596Email rmorris@retinanetwork.comPurpose: To present rapid and safe closure of the pit-macula communication (PMC) by core vitrectomy and adequate duration gas tamponade as our preferred method of resolving optic disc pit (ODP) maculopathy and to define the term “maculoschisis” in ODP maculopathy as an alternative to the term “schisis-like.&#x201DPatient and methods: A twenty-four-year-old female presented with an optical coherence tomography (OCT) confirmed ODP and a “giant” communicating maculoschisis cavity. Central macular thickness (CMT) measured 906 microns, and macular volume was twice normal, at 20.8 mm3. Snellen corrected visual acuity was 20/70. Two months after initial vitrectomy performed elsewhere with short-term gas tamponade (SF6 20%), CMT and visual acuity were not significantly improved. Combined lens extraction/intraocular lens placement and repeat vitrectomy with C3F8 15% gas tamponade were performed, with one supplemental (office) gas injection.Results: OCT imaging six weeks postoperatively showed definitive closure of the PMC with CMT reduced by 405 microns. Sequestered from its ODP source, foveal schisis fluid then resolved by 12 weeks postoperatively. At final follow-up 3.4 years postoperatively, the macula remained dry with a CMT of 322 microns and a concave foveal contour. Macular volume was reduced to (a normal) 10.2 mm3 and visual acuity had improved to 20/25.Conclusion: No report heretofore has documented rapid, sustained closure of the PMC by gas tamponade as the preferred method of expeditiously resolving ODP maculopathy. However, tamponade PMC closure sequesters ODP fluid and uniquely provides early assurance of ultimate maculopathy resolution. In all other techniques, PMC closure is a trailing phenomenon and success remains uncertain during months to a year or more of (unsequestered) fluid resolution. We suggest that more invasive techniques (laser barrier application to the peripapillary choroid, vitreoretinal interface maneuvers, and pit-plugging) be withheld unless a recurrence is detected during subsequent examinations.Keywords: optic disc pit, ODP, schisis, maculoschisis, ODP maculopathy, vitrectomy, tamponade, optical coherence tomography, OCT
format	article
author	Morris RE Hashimi H McFarland AJ Kuhn F Sapp M Oltmanns M
author_facet	Morris RE Hashimi H McFarland AJ Kuhn F Sapp M Oltmanns M
author_sort	Morris RE
title	Optic disc pit maculopathy: tamponade of maculoschisis
title_short	Optic disc pit maculopathy: tamponade of maculoschisis
title_full	Optic disc pit maculopathy: tamponade of maculoschisis
title_fullStr	Optic disc pit maculopathy: tamponade of maculoschisis
title_full_unstemmed	Optic disc pit maculopathy: tamponade of maculoschisis
title_sort	optic disc pit maculopathy: tamponade of maculoschisis
publisher	Dove Medical Press
publishDate	2019
url	https://doaj.org/article/e2eee6b3c1fb4e9e9307330006f398f7
work_keys_str_mv	AT morrisre opticdiscpitmaculopathytamponadeofmaculoschisis AT hashimih opticdiscpitmaculopathytamponadeofmaculoschisis AT mcfarlandaj opticdiscpitmaculopathytamponadeofmaculoschisis AT kuhnf opticdiscpitmaculopathytamponadeofmaculoschisis AT sappm opticdiscpitmaculopathytamponadeofmaculoschisis AT oltmannsm opticdiscpitmaculopathytamponadeofmaculoschisis
_version_	1718402500569071616

Optic disc pit maculopathy: tamponade of maculoschisis

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