J Korean Ophthalmol Soc.  2012 Apr;53(4):592-596.

A Case of Serous Macular Detachment Associated with Tractional Fibrous Tissue in an Optic Pit Patient

• Baek JS
• Cho SW

Abstract

PURPOSE
To report a case of serous macular detachment associated with tractional fibrous tissue in an optic pit patient successfully treated by vitrectomy without laser photocoagulation.
CASE SUMMARY
A 15-year-old female visited our hospital for visual disturbance of her left eye. The patient's best-corrected visual acuity was 0.5. After ophthalmic examinations, the patient was diagnosed with an optic pit associated serous macular detachment. Pars plana vitrectomy with complete posterior vitreous detachment was performed. A thick fibrous tissue within the optic disc cupping was found. During removal of the fibrous tissue, the tissue was observed to be attached to a tiny hole above the optic pit. The thick fibrous tissue was tugging at the margin of the hole and was removed using intraocular forceps to relieve the traction. Fluid-gas exchange was then performed and the operation was completed without laser photocoagulation around the optic disc. The fovea was reattached completely in 12 months and visual acuity was improved to 0.8.

Keyword

Laser photocoagulation; Optic pit; Serous macular detachment

MeSH Terms

Adolescent
Eye
Female
Humans
Light Coagulation
Surgical Instruments
Traction
Visual Acuity
Vitrectomy
Vitreous Detachment

Figure

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  Figure 1 Preoperative fundus photographs shows optic disc pit in temporal area and about 3D size serous retinal detachment.

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  Figure 2 Preoperative FAG and HRA show hyperfluorescence in macular area in early phase (A) and pooling of fluorescein in macular area in late phase (B).

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  Figure 3 Preoperative OCT (A) shows retinoschisis and subretinal fluid at the macular. The retinoschisis extended to the optic disc pit. Preoperative macular thickness was 772 µm on topography (B).

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  Figure 4 Thick fibrous tissue (arrow) existed on the cup of the optic nerve head (A). We found a tiny hole (arrow) above the optic pit during removal of the thick fibrous tissue (B).

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  Figure 5 Postoperative OCT shows decreased subretinal fluind and retinoschisis. (A) POD # 3 month, (B) POD # 6 month, (C) POD # 9 month, (D) POD # 12 month.

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