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New Surgical Technique for The Optic Disc Pit Associated with Macular Hole

Background: Optic disc pit is a congenital abnormality of the optic nerve head amaculopathy can develop in 25% to 75% of cases and usually confers a poor visual prognosis as a result of a longstanding serous macular detachment, formation of macular hole, and atrophy of the retinal pigmented epithelium. At the moment, there is not a single treatment that is universally accepted.

Method: A 65-year-old Caucasian man underwent a complete ophthalmological examination.

Results and discussion: Ophthalmoscopic examination and macular Optical Coherence Tomography showed in the right eye an optic disc pit maculopathy complicated by full thickness macular hole. Multifocal-Electroretinogram showed microvolted responses in all the regions. We performed in the right eye a 25 gauge pars plana triamcinolone-assisted vitrectomy with an inverted internal limiting membrane flap inserted both in the macular hole and in the optic disc pit. At 3 months from surgery the patient showed an improvement of macular structure and of visual function as well.

Conclusion: We report a case in which a “new” surgical approach was used in a patient affected by optic disc pit maculopathy complicated with a full thickness macular hole. Our technique was effective in improving the maculopathy and leading to an appreciable increase of the visual function; in particular, we found not only a significant improvement of visual acuity, but also of electrophisyological responses, considered by previous studies very sensitive in assessing functional alterations in this disease.


Settimio Rossi, Francesco Maria D’Alterio, Beatrice Gallo, Francesco Testa, Francesca Simonelli and Michele Della Corte

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