Published in:
01-07-2021 | Vitrectomy | Retinal Disorders
Intraoperative optical coherence tomography-assisted displacement of prepapillary membrane in eyes with optic disc pit maculopathy
Published in: Graefe's Archive for Clinical and Experimental Ophthalmology | Issue 7/2021
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Purpose
To determine the efficacy of displacing a prepapillary membrane during vitrectomy assisted by intraoperative optical coherence tomography (OCT) to treat eyes with optic disc pit maculopathy.
Method
Pars plana vitrectomy was performed with 27-gauge instruments on 4 eyes of 4 consecutive patients for optic disc pit maculopathy with retinoschisis and foveal detachment. After creating a posterior vitreous detachment, the prepapillary membrane was made visible by brilliant blue G staining. The membrane was peeled from the central retinal vessel and inverted and placed over intraretinal clefts or stuffed into the optic disc pit. These procedures were guided by intraoperative OCT. A gas tamponade and peripapillary laser was not used. The preoperative and postoperative OCT images and surgical outcomes were evaluated.
Result
Intraretinal clefts connected to an inner retinoschisis were detected at the edge of the optic disc pit in 3 eyes with intraoperative OCT and 2 eyes with preoperative OCT. The foveal detachment and retinoschisis were resolved completely in all 4 eyes at postoperative 13 to 15 months. The postoperative vision improved from 20/25 to 20/18 at the final examination in all eyes.
Conclusion
Intraoperative OCT can detect intraretinal clefts at the edge of the optic disc pit, and the OCT images are helpful in guiding the peeling and placement of the prepapillary membrane to achieve anatomical and visual recovery.
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