J Korean Ophthalmol Soc.  2014 Jan;55(1):138-142.

A Case of Serous Macular Detachment Preceding Macular Retinoschisis in an Optic Pit

• Yoon WT
• Kim KL
• Chang S
• Park SP

Abstract

PURPOSE
To report a case of serous macular detachment preceding macular retinoschisis in an optic pit patient successfully treated by vitrectomy with internal limiting membrane peeling.
CASE SUMMARY
A 76 year old female visited our clinic for visual disturbance in her right eye. Fundus photograph revealed optic pit and OCT showed macular retinoschisis in her right eye. She was followed up in our clinic. The patient revisited our clinic because of sudden decrease of visual acuity in her right eye 3 days before. At that time, the patient's best-corrected visual acuity was 0.05. Macular retinoschisis, subretinal fluid and serous retinal detachment were observed in her right eye on OCT. She was diagnosed with serous retinal detachment associated with optic pit and pars plana vitrectomy was performed. During vitrectomy, we found adhesion and defect of posterior hyaloid membrane which covered the optic pit. Therefore, subretinal fluid was drained via membrane defect and posterior vitreous detachment and fluid-gas exchange were induced. Sixteen days after surgery, we found a macular hole in her right eye on OCT. Pars plana vitrectomy was performed with internal limiting membrane peeling. One month after surgery, macular detachment was not observed. Six months after surgery, the patient's best corrected visual acuity was 0.63 and the macula was reattached completely.
CONCLUSIONS
Optic pit maculopathy can be progressed rapidly in aged patients and macular hole would be ocurred as a complication. Additional study will be needed to figure out the role of internal limiting membrane and tractional force of posterior vitreous in these patients.

Keyword

Internal membrane peeling; Optic pit; Retinoschisis; Serous retinal detachment; Vitrectomy

MeSH Terms

Female
Humans
Membranes
Retinal Detachment
Retinal Perforations
Retinoschisis*
Subretinal Fluid
Traction
Visual Acuity
Vitrectomy
Vitreous Detachment

Figure

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  Figure 1. (A, B) Fundus photograph the infrared photograph show optic pit in the temporal area of the optic disc at the first visit, (C) OCT shows retinoschisis (1) and optic pit (2) at the disc.

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  Figure 2. From 2006 to 2010, OCT shows progressed retinoschisis at the macula. (A): 2006, BCVA 0.2, (B): 2008, BCVA 0.2, (C): 2010, BCVA 0.2.

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  Figure 3. (A) Preoperative OCT shows retinoschisis and serous retinal detachment at the macula. (B) Postoperative 9 days, OCT shows decrease of subretinal fluid and retinoschisis. (C) Postoperative 16 days, OCT shows subretinal fluid and the macular hole. (D) Postoperative 6 months, OCT shows decreased subretinal fluid and retinoschisis.

Reference

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