First Author: M.Pefkianaki UK
Co Author(s): A. Moore 0 0 0 0 0 0 0 0 0
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The aim of this small case series is to report and discuss the clinical findings of two cases with optic disc pit (ODP)-related serous macular detachment and their different management.
A retrospective study of two patients with optic disc pit maculopathy ,who have been attending the genetic clinics of Moorfields Eye Hospital
Case1: Funduscopic examination of a six year old girl with best visual acuities 6/6 in the right eye and 6/5 in the left eye showed a serous detachment of the retina at the left macula with a left optic disc pit. Three years after the first presentation her vision dropped to 6/18 in that eye and she was found to have subretinal fluid and schisis evident on the OCT. A conservative approach to management was taken . Two years later the vision in the left eye was 6/9 and there was only minimal schitic change on the OCT scanning Case 2: A ten year old girl was referred with decreased visual acuity in the left eye.The visual acuity was 6/6 in the right eye and 6/60 in the left.Funduscopy of the left eye revealed an optic disc pit, serous detachment, and subretinal precipitates in the macula. Subsequently the vision in the left eye deteriorated to 1/60. She underwent an uneventful left vitrectomy with laser and intraocular gas tamponade. One year after the surgery the visual acuity was 6/24 and OCT examination showed a residual shallow area of subretinal fluid at the macula.
ODP is a rare congenital abnormality which generally asymptomatic unless it is complicated by serous detachment at the macula. This is usually accompanied by a degree of retinoschisis. The pathogenesis of the serous retinal detachment (SRD) remains controversial. Many cases can be managed conservatively (as in case 1), but surgery is indicated when there is progressive visual loss. Vitrectomy, intraocular gas +/- laser is the preferred approach (case 2)
These two cases illustrate the importance of OCT findings in diagnosis and monitoring progression.