Session Title: Vitreoretinal Surgery IV
Session Date/Time: Friday 27/09/2013 | 16:30-18:00
Paper Time: 17:18
Venue: Hall 3 (Level 0)
First Author: R.Avci TURKEY
Co Author(s): Z. Kapran S. Ozdek M. Teke D. Guven
Given the unfavorable natural history of optic disc pit maculopathy (ODP-M), treatment most commonly with vitrectomy is usually recommended by vitreoretinal specialists. However, there are many combination techniques even if vitrectomy is chosen as primary procedure. In literature, related case reports are in majority consist of one or up to one dozen eyes. Because of rarity of this entity, there is a need to collect cases from numerous centers to infer more generalized opinion about the outcomes of surgeries for ODP-M. We presented outcomes of largest series reported up to date, which treated by different vitreoretinal surgical techniques.
Retrospective interventional consecutive case series from 11 tertiary centers
This study included 32 eyes of 31 patients with ODP-M who underwent pars plana vitrectomy with various adjunctive techniques. The effectiveness of barrage laser photocoagulation, internal limiting membran peeling and type of intraocular tamponade and triamcinolone assisted posterior hyaloid removal as an additional surgical step was evaluated. Eyes were categorized according to additional surgical steps. Patients were observed for 12 to 66 months (mean, 24.8) after surgery. Anatomic outcome and best-corrected visual acuity (BCVA) were retrospectively analyzed for all eyes and for all categories. Preoperative and final foveal thickness and anatomic changes in the macula was evaluated by optical coherence tomography.
Mean age of 10 men and 21 women was 32.7±16.6 years (6 to 68 years old). Mean preoperative foveal thickness was 690.2±259.6µm and improved to 280.8±120.6 µm. Mean preoperative BCVA was 20/400 (range 20/20000-20/40). Twenty-seven eyes (84%) gained 2 or more Snellen lines of vision. Mean final BCVA was 20/80 (range 20/800-20/20) with 13 eyes having 20/40 or more BCVA. Visual acuity improved statistically after surgery, as the ODP-M was resolved progressively in all adjuvant categories. Complete retinal reattachment was achieved in 25 of 32 eyes. No recurrences were observed except one eye during the follow-up period. Statistically significant differences were not observed among the adjuvant categories according to surgical outcome parameters. ILM peeling was performed in only 6 eyes from our series based on surgeon preference, but not yielded better surgical outcomes.
These results suggest that pars plana vitrectomy with either adjuvant category is successful in reattaching the macula and improving the visual acuity in most eyes with ODP-M. ILM peeling may not be necessary to achieve favorable results.