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  • Comparison of various surgical techniques for optic disc pit maculopathy: vitrectomy with internal limiting membrane (ILM) peeling alone versus inverted ILM flap ‘plug’ versus autologous scleral ‘plug’

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Clinical science
Comparison of various surgical techniques for optic disc pit maculopathy: vitrectomy with internal limiting membrane (ILM) peeling alone versus inverted ILM flap ‘plug’ versus autologous scleral ‘plug’
  1. Naresh Babu,
  2. Piyush Kohli,
  3. Kim Ramasamy
  1. Vitreo-retinal Services, Aravind Eye Hospital, Madurai, India
  1. Correspondence to Dr Piyush Kohli, Vitreo-retinal services, Aravind Eye Hospital, Madurai, India; kohli119{at}gmail.com

Abstract

Aim To compare the anatomical and visual outcomes of vitrectomy with internal limiting membrane (ILM) peeling alone versus inverted ILM flap to plug the pit versus autologous scleral plug for the treatment of optic disc pit maculopathy (ODP-M).

Methods This retrospective study included 23 patients (23 eyes) who underwent 25G pars plana vitrectomy, ILM peeling and gas tamponade. While the pit was not plugged in group 1 (n=8), inverted ILM flap and autologous scleral flap were used to plug the pit in group 2 (n=7) and group 3 (n=8), respectively. Complete anatomical success was defined as total resolution of subretinal fluid (SRF) and macular schisis on optical coherence tomography while visual success was defined as a gain of at least 2 Snellen lines 1 year after surgery.

Results Baseline characteristics were similar in all three groups. Mean central foveal thickness and SRF decreased in all three groups (p<0.05). Complete anatomical success was achieved in 25.0%, 85.7% and 87.5% eyes while visual success was achieved in 12.5%, 28.6% and 12.5% eyes in groups 1, 2 and 3, respectively. One eye (4.3%) in group 2 developed full-thickness macular hole at 1 month post-surgery. After complete resolution, there was no recurrence of fluid.

Conclusion OPD-M has a better surgical outcome if the pit is plugged. Both inverted ILM flap and autologous scleral plug are equally efficacious adjuncts to plug the pit.

  • ILM peeling
  • ILM flap
  • Macular hole
  • optic disc pit maculopathy (ODPM)
  • outer retinal hole (ORH)
  • scleral plug

https://doi.org/10.1136/bjophthalmol-2019-315075

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    Footnotes

    • Twitter Kim Ramasamy@Kim

    • Contributors NB: substantial contributions to the conception and design of the work; acquisition, analysis and interpretation of data; revising the work critically for important intellectual content; final approval of the version published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. PK: substantial contributions to the conception and design of the work; acquisition, analysis and interpretation of data; drafting the work and revising the work critically for important intellectual content; final approval of the version published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. KR: substantial contributions to the conception and design of the work; acquisition, analysis and interpretation of data; revising the work critically for important intellectual content; final approval of the version published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Parental/guardian consent obtained.

    • Ethics approval The study was conducted with the approval of the Institutional Review Board (registration no. ECR/ 182/INST/TN/ 2013, dated 20 Apr 2013, project code RET201200223) and adhered to the tenets of the Declaration of Helsinki.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement Data are available in a public, open-access repository.