Improvement in visual function after displacement of the retinal elevations emanating from optic pits
H. Lincoff, L. Yannuzzi, L. Singerman, I. Kreissig and Y. Fisher
New York (NY) Hospital-Cornell Medical Center.
OBJECTIVE: To define the functional deficit that correlates with the inner
layer separation and the outer layer detachment that have been observed in
optic pit maculopathy and to determine the effect of a gas tamponade that
compresses or displaces the two layers. DESIGN: The central visual field
before and after a gas tamponade on the posterior pole were charted on a
1-m tangent screen and compared with the changes in the retina observed
biomicroscopically and with stereophotography. SETTING: The gas operations
were done at four hospitals in the New York, NY, area and one in Cleveland,
Ohio. The retinal examinations, visual field testing, and stereoscopic
photography for eight patients were done at The New York Hospital. The
patient who lived in Cleveland was examined and photographed in Cleveland.
PARTICIPANTS: Nine patients between the ages of 18 and 46 years with optic
pit maculopathy. INTERVENTION: The patients were operated on by five
retinal surgeons with a variety of procedures. Four patients had a
vitrectomy and intraocular gas injected. Five patients had gas injected
after external compression. Two patients had laser applied in conjunction
with the intraocular injection. The gas tamponade was the unifying factor.
RESULTS: The dense central scotoma in optic pit maculopathy relates to the
outer layer detachment and displacement of it from the posterior pole
yields an improvement in visual acuity. The inner layer separation persists
centrally after a gas tamponade and continues to provide access for the
flow of fluid from the pit. The scotoma that relates to the inner layer
separation is mild and consistent with relatively good visual acuity.
