Autologous internal limiting membrane flap techniques for optic disc pit maculopathy

Session Details

Session Title: Free Paper Session 1: Vitreoretinal Surgery I

Session Date/Time: Thursday 07/09/2017 | 09:00-10:30

Paper Time: 09:48

Venue: Room 111

First Author: : C.Garcia Arumi SPAIN

Co Author(s): :    S. Pastor Idoate   J. Nadal   J. Garcia Arumi                       

Abstract Details

Purpose:

To evaluate the translocation and transplantation of inverted autologous internal limiting membrane (ILM) flap techniques for the treatment of chronic, and/or refractory optic disc pit (ODP) maculopathy and how swept-source optical coherence tomography (SS-OCT) provides enhanced diagnostic information enabling optimization of surgical strategy in patients suffering from ODP maculopathy.

Setting:

Prospective interventional case series involving Vall d’Hebron Hospital (HVH) (Barcelona, Spain), Ocular Microsurgery Institute (IMO) (Barcelona, Spain) and Barraquer Ophthalmology centre (Barcelona, Spain) from September 2015 to January 2017.

Methods:

7 eyes of 7 patients with ODP maculopathy underwent pars plana vitrectomy (PPV) and ILM peeling followed by positioning of the ILM remnant to cover the optic disc. Perfluorocarbon liquid was employed to facilitate the manipulation of the ILM. Fluid–air exchange and gas tamponade were then performed. OCT and clinical examinations were done before, during the surgery and postoperatively at 1 week and 1, 3 and 6 months. Follow-up period ranged from 6 to 16 months.

Results:

Preoperative foveal thickness mean was 709,4µm. Satisfactory postoperative maculopathy thickness reduction was observed in all cases, beyond 6 months after surgery, with a mean reduction of 327,3µm (p<0.05). Preoperative visual acuity improved from a mean of 20/63 in the preoperative period to 20/30 at 6 months after surgery (p<0.05). The presence of postoperative ILM flap as a hyperreflective line at the base of the optic nerve excavation was observed in all SS-OCT cases.

Conclusions:

Treatment with autologous ILM flap techniques could be an alternative treatment for chronic and/or refractory ODP maculopathy. In our case series SS-OCT improved the visualization of cortical vitreous, highlighted the position of the inverted flap and could assist in the choice of surgical technique comparing to SD-OCT.

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