First Author: P.Turkcuoglu TURKEY
Co Author(s): C. Taskapan 0 0 0 0 0 0 0 0 0
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To document a surgical technique for the drainage of the leaking fluid over the optic pit and the origin of subretinal fluid in optic disc pit maculopathy.
In an eye hospital settled in southeastern region of Turkey.
We report two cases of optic disc pit maculopathy where pars plana vitrectomy was combined with a surgical technique for the drainage of the leaking fluid over the optic pit. First case was a 23- year-old female and the second case a 13-year-old female. Optical coherence tomography (OCT) images obtained with RTvue-100 OCT (Optovue Inc., Fremont, CA) revealed subretinal fluid without any outer nuclear layer schisis in both patient. Neither posterior vitreous detachment nor vitreomacular traction was observed. Pars plana vitrectomy, internal limiting membrane peeling followed by gas tamponade (SF6 %20) was conducted. During the fluid-air exchange the eye was fully dried and then the air infusion pressure was decreased to 5 mmHg till the level of the fluid coming from the optic disc pit covered the macular area. Then the infusion pressure was raised to 25 mmHg and the collected fluid was drained with back-flush needle over the optic nerve and the fluid inside the back-flush needle was spitted to microcentrifuge tube. This procedure was repeated for several times until 1 cc sample was collected. Biochemical analyses of the fluids were conducted in order to find its origin.
The results of the first case sample were chloride 125 mmol/L , sodium 146 mmol/L, potassium 2.8 mmol/L, protein 29 mg/dL, glucose 60 mg/dL. The results of the second case sample were chloride 122 mmol/L, sodium 147 mmol/L, potassium 3.0 mmol/L, protein 18.4 mg/dL, glucose 57 mg/dL. Both patients’ results were compatible with the normal cerebrospinal fluid chloride (range 115 to 130 mmol/L), sodium (range 135-150 mmol/L), potassium (range 2.6-3.0 mmol/L), protein (range 15 to 40 mg/dL) and glucose (range 50 to 80 mg/dL) levels.
With these findings we can strongly suggest that the origin of the subretinal fluid in optic disc pit maculopathy is cerebrospinal fluid.