Treatment of maculopathy associated with optic disk pit by sponge explant

To evaluate the anatomic and functional outcome in nine patients with optic disk pit maculopathy after the use of the macular buckling procedure.

In this prospective study, nine consecutive patients (five women and four men with a mean age of 28 years [range, 14 to 49 years] who had unilateral maculopathy associated with optic disk pit) were treated with macular buckling surgery. A scleral sponge of 7.5 x 5.5 mm was fixed at the posterior pole of the globe corresponding to the macula along the vertical axis of the 12-to-6 o'clock meridian. No additional treatment of any kind (laser, diathermy, or cryotherapy) was used. The correct positioning of the sponge during the operation was monitored by B-scan ultrasonography. Within the first week after surgery, indocyanine green angiography was performed to evaluate the choroidal circulation. During the same period, magnetic resonance imaging of the orbit was performed to determine the sponge position in relation to the optic nerve.

In all nine eyes, complete disappearance of subretinal and intraretinal fluid in the macula and in the surrounding area was noted. The absorption of the macular fluid started immediately after the operation and was completed after five to six months. No further change of the appearance of the fundus was noted during the follow-up period, which ranged from 18 to 66 months (mean follow-up, 42 months). Six eyes gained four or five lines of visual acuity, and two eyes improved by three lines.

The macular scleral buckling procedure in optic disk pit maculopathy can yield favorable anatomic and functional results.