Laser photocoagulation or endolaser combined with vitrectomy for congenital optic disc pit maculopathy: “dam sign” of optical coherence tomography is a sign to indicate the anatomic success_Chinese Journal of Ocular Fundus Diseases

Authors：

Huang Li , Lyu Cancan , Li Jun ,  Lyu Lin

State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China;

Corresponding author：

Lyu Lin, Email: lulin@gzzoc.com

Keywords：

Optic disk/abnormalities; Laser coagulation; Vitrectomy; Tomography, optical coherence; Dam sign change

DOI：

10.3760/cma.j.issn.1005-1015.2019.06.012

Video：

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Objective To investigate the successful signs of laser photocoagulation or endolaser combined vitrectomy for congenital optic disc pit (ODP) with serous macular detachment.Methods A retrospective case analysis. Twelve eyes of 12 patients with congenital ODP complicated with serous macular detachment diagnosed in Zhongshan Ophthalmic Center from 2003 to 2018 were included in this study. There were 2 males (2 eyes) and 8 females (8 eyes). The average age was 30.17 years old. Retinal laser photocoagulation and/or vitrectomy were performed in all the eyes. The optic disc and macular area were scanned using the tracking mode of the Germany Heidelberg Spectralis OCT instrument. The " dam-sign” change was a retinal choroidal scar on the channel between the ODP and the macula on the OCT image after treatment. The eyes were divided into a " dam-sign” change group (group A, 10 eyes) and no " dam-sign” change group (group B, 2 eyes). The BCVA of eyes in group A was 0.03-0.6. In group A, 1 eye was treated with laser photocoagulation alone, 9 eyes were treated with vitrectomy combined with laser photocoagulation. The BCVA of eyes in group B was 0.1. All the eyes in group B underwent vitrectomy combined with laser photocoagulation. The follow-up was ranged from 6 to 174 months. The same equipment and method before treatment were used for 1, 3, 6, 12, 18, and 24 months after treatment. The BCVA, absorption of subretinal fluid (SRF) and the formation of " dam-sign” change were observed.Results At the last follow-up, the BCVA of eyes in group A was 0.4-1.0 (0.4 in 1 eye, 0.5 in 3 eyes, 0.6 in 2 eyes, 0.8 in 3 eyes, 1.0 in 1 eye). In 9 eyes treated with vitrectomy combined with laser photocoagulation, SRF was completely absorbed. In 1 eye treated with laser photocoagulation alone, SRF remained in small amount. The BCVA of the two eyes in group B was 0.03 and 0.3, respectively; and SRF was not absorbed in both of them.Conclusions The " dam-sign” change near optic disc after laser photocoagulation can promote SRF absorption and improve BCVA. It can be used as a success indicator after treatment.

Citation： Huang Li, Lyu Cancan, Li Jun, Lyu Lin. Laser photocoagulation or endolaser combined with vitrectomy for congenital optic disc pit maculopathy: “dam sign” of optical coherence tomography is a sign to indicate the anatomic success. Chinese Journal of Ocular Fundus Diseases, 2019, 35(6): 580-583. doi: 10.3760/cma.j.issn.1005-1015.2019.06.012 Copy

1.	Kranenburg EW. Crater-like holes in the optic disc and central serous retinopathy[J]. Arch Ophthalmol, 1960, 64: 912-924. DOI: 10.1001/archopht.1960.01840010914013.
2.	Georgalas I, Ladas I, Georgopoulos G, et al. Optic disc pit: a review[J]. Graefe's Arch Clin Exp Ophthalmol, 2011, 249(8): 1113-1122. DOI: 10.1007/s00417-011-1698-5.
3.	Uzel MM, Karacorlu M. Optic disk pits and optic disk pit maculopathy: a review[J]. Surv Ophthalmol, 2019, 64(5): 595-607. DOI: 10.1016/j.survophthal.2019.02.006.
4.	Theodossiadis G. Treatment of retinal detachment with congenital optic pit by krypton laser photocoagulation[J]. Graefe's Arch Clin Exp Ophthalmol, 1988, 226(3): 299. DOI: 10.1007/bf02181201.
5.	Lei L, Li T, Ding X, et al. Gas tamponade combined with laser photocoagulation therapy for congenital optic disc pit maculopathy[J]. Eye (Lond), 2015, 29(1): 106-114. DOI: 10.1038/eye.2014.245.
6.	Georgalas I, Petrou P, Koutsandrea C, et al. Optic disc pit maculopathy treated with vitrectomy, internal limiting membrane peeling, and gas tamponade: a report of two cases[J]. Eur J Ophthalmol, 2009, 19(2): 324-326. DOI: 10.1177/112067210901900230.
7.	Theodossiadis GP, Theodossiadis PG. The macular buckling technique in the treatment of optic disk pit maculopathy[J]. Semin Ophthalmol, 2000, 15(2): 108-115. DOI: 10.153/SOPH01500108.
8.	Wan R, Chang A.Optic disc pit maculopathy: a review of diagnosis and treatment[J]. Clin Exp Optom, 2019, 2019:E1[2019-08-22]. https://doi.org/10.1111/cxo.12957. DOI: 10.1111/cxo.12957. [published online ahead of print].
9.	Sugar HS. An explanation for the acquired macular pathology associated with congenital pits of the optic disc[J]. Am J Ophthalmol, 1964, 57: 833-835. DOI: 10.1016/0002-9394(64)92235-4.
10.	Brown GC, Shields JA, Patty BE, et al. Congenital pits of the optic nerve head.Ⅰ. Experimental studies in collie dogs[J]. Arch Ophthalmol, 1979, 97(7): 1341-1344. DOI: 10.1001/archopht.1979.01020020083020.
11.	Gass JD. Serous detachment of the macula: secondary to congenital pit of the optic nervehead[J]. Am J Ophthalmol, 1969, 67(6): 821-841. DOI: 10.1016/0002-9394(69)90075-0.
12.	Gowdar JP, Rajesh B, Giridhar A, et al. An insight into the pathogenesis of optic disc pit-associated maculopathy with enhanced depth imaging[J]. JAMA Ophthalmol, 2015, 133(4): 466-409. DOI: 10.1001/jamaophthalmol.2014.6093.
13.	Jain N, Johnson MW. Pathogenesis and treatment of maculopathy associated with cavitary optic disc anomalies[J]. Am J Ophthalmol, 2014, 158(3): 423-435. DOI: 10.1016/j.ajo.2014.06.001.
14.	García-Arumí J, Guraya BC, Espax AB, et al. Optical coherence tomography in optic pit maculopathy managed with vitrectomy-laser-gas[J]. Graefe's Arch Clin Exp Ophthalmol, 2004, 242(10): 819-826. DOI: 10.1007/s00417-004-0897-8.
15.	Teke MY, Citirik M. 23 gauge vitrectomy, endolaser, and gas tamponade versus vitrectomy alone for serous macular detachment associated with optic disc pit[J]. Am J Ophthalmol, 2015, 160(4): 779-785. DOI: 10.1016/j.ajo.2015.07.019.

1. Kranenburg EW. Crater-like holes in the optic disc and central serous retinopathy[J]. Arch Ophthalmol, 1960, 64: 912-924. DOI: 10.1001/archopht.1960.01840010914013.
2. Georgalas I, Ladas I, Georgopoulos G, et al. Optic disc pit: a review[J]. Graefe's Arch Clin Exp Ophthalmol, 2011, 249(8): 1113-1122. DOI: 10.1007/s00417-011-1698-5.
3. Uzel MM, Karacorlu M. Optic disk pits and optic disk pit maculopathy: a review[J]. Surv Ophthalmol, 2019, 64(5): 595-607. DOI: 10.1016/j.survophthal.2019.02.006.
4. Theodossiadis G. Treatment of retinal detachment with congenital optic pit by krypton laser photocoagulation[J]. Graefe's Arch Clin Exp Ophthalmol, 1988, 226(3): 299. DOI: 10.1007/bf02181201.
5. Lei L, Li T, Ding X, et al. Gas tamponade combined with laser photocoagulation therapy for congenital optic disc pit maculopathy[J]. Eye (Lond), 2015, 29(1): 106-114. DOI: 10.1038/eye.2014.245.
6. Georgalas I, Petrou P, Koutsandrea C, et al. Optic disc pit maculopathy treated with vitrectomy, internal limiting membrane peeling, and gas tamponade: a report of two cases[J]. Eur J Ophthalmol, 2009, 19(2): 324-326. DOI: 10.1177/112067210901900230.
7. Theodossiadis GP, Theodossiadis PG. The macular buckling technique in the treatment of optic disk pit maculopathy[J]. Semin Ophthalmol, 2000, 15(2): 108-115. DOI: 10.153/SOPH01500108.
8. Wan R, Chang A.Optic disc pit maculopathy: a review of diagnosis and treatment[J]. Clin Exp Optom, 2019, 2019:E1[2019-08-22]. https://doi.org/10.1111/cxo.12957. DOI: 10.1111/cxo.12957. [published online ahead of print].
9. Sugar HS. An explanation for the acquired macular pathology associated with congenital pits of the optic disc[J]. Am J Ophthalmol, 1964, 57: 833-835. DOI: 10.1016/0002-9394(64)92235-4.
10. Brown GC, Shields JA, Patty BE, et al. Congenital pits of the optic nerve head.Ⅰ. Experimental studies in collie dogs[J]. Arch Ophthalmol, 1979, 97(7): 1341-1344. DOI: 10.1001/archopht.1979.01020020083020.
11. Gass JD. Serous detachment of the macula: secondary to congenital pit of the optic nervehead[J]. Am J Ophthalmol, 1969, 67(6): 821-841. DOI: 10.1016/0002-9394(69)90075-0.
12. Gowdar JP, Rajesh B, Giridhar A, et al. An insight into the pathogenesis of optic disc pit-associated maculopathy with enhanced depth imaging[J]. JAMA Ophthalmol, 2015, 133(4): 466-409. DOI: 10.1001/jamaophthalmol.2014.6093.
13. Jain N, Johnson MW. Pathogenesis and treatment of maculopathy associated with cavitary optic disc anomalies[J]. Am J Ophthalmol, 2014, 158(3): 423-435. DOI: 10.1016/j.ajo.2014.06.001.
14. García-Arumí J, Guraya BC, Espax AB, et al. Optical coherence tomography in optic pit maculopathy managed with vitrectomy-laser-gas[J]. Graefe's Arch Clin Exp Ophthalmol, 2004, 242(10): 819-826. DOI: 10.1007/s00417-004-0897-8.
15. Teke MY, Citirik M. 23 gauge vitrectomy, endolaser, and gas tamponade versus vitrectomy alone for serous macular detachment associated with optic disc pit[J]. Am J Ophthalmol, 2015, 160(4): 779-785. DOI: 10.1016/j.ajo.2015.07.019.

Chinese Journal of Ocular Fundus Diseases

Laser photocoagulation or endolaser combined with vitrectomy for congenital optic disc pit maculopathy: “dam sign” of optical coherence tomography is a sign to indicate the anatomic success

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