Medical Case Reports

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.

Author(s):

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

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