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SURGICAL DEMONSTRATION OF PRESSURE DIFFERENTIAL THROUGH AN OPTIC DISK PIT.

James C Rice¹, Raoul P Scholtz, Joseph Joseph

¹Department of Ophthalmology, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa.

Retinal Cases & Brief Reports

|February 2, 2023

Summary

This study demonstrates dynamic flow within an optic disk pit during surgery. Changes in intraocular pressure caused vitreous to move into and out of the pit, showing a pressure differential.

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Optic Nerve Sheath Point of Care Ultrasound: Image Acquisition

Optic Nerve Sheath Point of Care Ultrasound: Image Acquisition

Published on: August 18, 2023

Area of Science:

Ophthalmology
Retinal Surgery

Background:

Optic disk pits are congenital abnormalities.
The pathophysiology of optic disk pits and their communication with the vitreous or subarachnoid space remains incompletely understood.

Purpose of the Study:

To visualize and demonstrate intraoperative dynamic flow through an optic disk pit.
To provide evidence for the communication between the vitreous cavity and the optic nerve's perineural space.

Main Methods:

Retrospective interventional case report.
Standard 25-gauge pars plana vitrectomy.
Induction of posterior hyaloid separation with triamcinolone stain, temporal peripapillary laser, and sulfur hexafluoride (SF 6) gas injection.

Main Results:

Intraoperative observation of vitreous prolapsing into the optic disk pit with increased intraocular pressure.
Demonstration of vitreous being drawn back into the vitreous cavity as intraocular pressure was reduced.
Clear evidence of a pressure differential across the optic disk pit.

Conclusions:

Histological evidence supports communication between the vitreous cavity and the optic nerve's perineural space.
This case provides intraoperative visualization of dynamic flow through an optic disk pit.
The observed flow is influenced by intraocular pressure fluctuations.