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      Surgical treatment of macular detachment secondary to congenital pit of the optic disc: case report Translated title: Tratamento cirúrgico do descolamento macular secundário à fosseta congênita do disco óptico: relato de caso

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          Abstract

          The authors describe a patient with macular detachment in the right eye, secondary to congenital pit of the optic disc, submitted to vitrectomy, drainage of the subretinal fluid, perfluorocarbon, endolaser and perfluoropropane gas (C3F8). A sample of the vitreous humor was taken for comparative analysis with the subretinal fluid. Results of retinography, optical coherence tomography, and illustrations of the surgical procedure are presented. Optical coherence tomography revealed the detachment resolved 6 months after surgery. Visual acuity improved from 20/400 to 20/30. This surgical technique can lead to successful reattachment of the macula and improvement of central vision. Additionally, a qualitative and comparative analysis showed a similar biochemical composition of the subretinal fluid and the vitreous. Despite technical limitations, this analysis can confirm the pathophysiology of the disease, suggesting that the subretinal fluid may originate from the vitreous cavity in macular detachment secondary to congenital pit of the optic disc.

          Translated abstract

          Os autores descrevem um paciente portador de descolamento macular secundário à fosseta congênita do nervo óptico no olho direito, submetido à vitrectomia, drenagem do fluido sub-retiniano, perfluorcarbono, endolaser e gás perfluoropropano (C3F8). Foi retirada amostra do humor vítreo para análise comparativa com o fluido sub-retiniano. São apresentadas retinografia, tomografia de coerência óptica e ilustrações do procedimento cirúrgico. Após 6 meses da cirurgia, houve resolução do descolamento evidenciada por meio da tomografia de coerência óptica. A acuidade visual melhorou de 20/400 para 20/30. A técnica cirúrgica utilizada pode ter melhorado os resultados obtidos. Adicionalmente, a análise bioquímica qualitativa e comparativa do fluido sub-retiniano e do vítreo mostrou composição semelhante. Apesar das limitações técnicas, esta análise pode corroborar na fisiopatogênese da doença, sugerindo que o fluido sub-retiniano pode ser originado da cavidade vítrea na fosseta congênita de papila.

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          Most cited references28

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          Crater-like holes in the optic disc and central serous retinopathy.

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            Serous detachment of the macula. Secondary to congenital pit of the optic nervehead.

            J Gass (1969)
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              Congenital optic disk anomalies.

              M Brodsky (2015)
              Over the past decade, a wealth of information has accumulated pertaining to the diagnosis and management of patients with congenital optic disk anomalies. As new examples of each entity have been detailed, the diagnostic criteria for each anomaly have become more clearly defined. The advent of sophisticated noninvasive neuroimaging techniques has further refined our ability to accurately detect and categorize the associated CNS anomalies that complicate many of these conditions. In light of recent findings, this review will critically examine many of the well-entrenched concepts pertaining to the diagnosis, evaluation, and treatment of patients with congenital optic disk anomalies. In so doing, it will attempt to dispel some longstanding misconceptions that pervade the literature and obscure our understanding of the pathogenesis, neuroradiological associations, and systemic implications of each anomaly.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                abo
                Arquivos Brasileiros de Oftalmologia
                Arq. Bras. Oftalmol.
                Conselho Brasileiro de Oftalmologia (São Paulo )
                1678-2925
                December 2008
                : 71
                : 6
                : 874-877
                Affiliations
                [1 ] Monte Tabor Foundation Brazil
                [2 ] Universidade de São Paulo Brazil
                [3 ] Universidade de São Paulo Brazil
                Article
                S0004-27492008000600022
                10.1590/S0004-27492008000600022
                910382c6-ce11-4e5b-bebe-14035b5fad39

                http://creativecommons.org/licenses/by/4.0/

                History
                Product

                SciELO Brazil

                Self URI (journal page): http://www.scielo.br/scielo.php?script=sci_serial&pid=0004-2749&lng=en
                Categories
                OPHTHALMOLOGY

                Ophthalmology & Optometry
                Optic nerve,Vitreous body,Vitrectomy,Retinal detachment,Tomography, optical coherence,Case reports,Nervo óptico,Corpo vítreo,Vitrectomia,Descolamento retiniano,Tomografia de coerência óptica,Relatos de casos

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