Surgical Options for Optic Disc Pit Maculopathy: Perspectives and Controversies

Area of Science:

• Ophthalmology
• Retinal Diseases
• Congenital Abnormalities

Background:

• Optic disc pit (ODP) is a rare congenital optic nerve head abnormality.
• ODP can lead to ODP-maculopathy, characterized by intraretinal and subretinal fluid, causing progressive visual loss.
• The fluid source in ODP-maculopathy is unclear, with hypotheses including vitreous or cerebrospinal fluid.

Purpose of the Study:

• To review and analyze surgical treatment modalities for ODP-maculopathy.
• To identify the most effective surgical options for managing ODP-maculopathy.
• To address the challenge of treatment comparison due to the rarity of the condition.

Main Methods:

• Mini-review of existing literature on surgical treatments for ODP-maculopathy.
• Analysis of reported outcomes for various surgical procedures.
• Comparison of different surgical techniques and adjuvant therapies.

Main Results:

• Spontaneous resolution of ODP-maculopathy is uncommon.
• Untreated ODP-maculopathy often results in severe visual impairment (worse than 20/200).
• Surgical procedures involving filling the ODP with self-sealing materials combined with pars plana vitrectomy have shown effectiveness.

Conclusions:

• Optimal treatment for ODP-maculopathy remains challenging due to limited comparative data.
• Surgical intervention, particularly ODP filling with vitrectomy, appears to be a promising approach.
• Further research and larger case series are needed to establish a consensus on the best surgical management.