Optic disc pit – Sourceshed

Summary of Evidence

Incidence of maculopathy

The general incidence of maculopathy in optic disc pit (ODP) is 51%, and the rate of serous macular detachment and retinoschisis is 49% and 58%, respectively. {Meng L, Zhao X, Zhang W, Wang D, Chen Y. The characteristics of optic disc pit maculopathy and the efficacy of vitrectomy: a systematic review and meta-analysis. Acta Ophthalmol. 2021 Nov;99(7):e1176-e1189.}

Vitrectomy

There were no significant differences in outcomes among 6 different surgical techniques in the treatment of optic pit maculopathy. {Zheng A, Singh RP, Lavine JA. Surgical Options and Outcomes in the Treatment of Optic Pit Maculopathy: A Meta-analysis and Systematic Review. Ophthalmol Retina. 2020 Mar;4(3):289-299.}

PPV alone
PPV plus juxtapapillary laser treatment (JPL)
PPV plus internal limiting membrane peeling (ILMP)
PPV plus both ILMP and JPL
PPV plus inner retinal fenestration
PPV plus autologous platelet concentrate

Evidence

1. General

Review

2020 Wan & Chang

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2020
Review

Review

2019 Kalogeropoulos et.al.

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2019
Review

Summary of the potential pathogenesis, diagnostic and therapeutic approach of optic disc pit maculopathy. {Kalogeropoulos D, Ch’ng SW, Lee R, Elaraoud I, Purohit M, Felicida V, Mathew M, Ajith-Kumar N, Sharma A, Mitra A. Optic Disc Pit Maculopathy: A Review. Asia Pac J Ophthalmol (Phila). 2019 May-Jun;8(3):247-255.}

Kalogeropoulos et.al.
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Review

2019 Uzel & Karacorlu

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2019
Review

Review

2015 Moisseiev et.al.

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2015
Review

Review of mechanisms of pathogenesis in optic disc pit maculopathy (ODP-M), treatment modalities and their results. {Moisseiev E, Moisseiev J, Loewenstein A. Optic disc pit maculopathy: when and how to treat? A review of the pathogenesis and treatment options. Int J Retina Vitreous. 2015 Aug 7;1:13.}

1.1 Optic disc pit maculopathy and other complications

Systematic review

2021 Meng et.al.

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2021
Systematic review

Systematic review of 59 studies on characteristics and treatment options of optic disc pit maculopathy.

The general incidence of maculopathy in optic disc pit (ODP) is 51%, and the rate of serous macular detachment and retinoschisis is 49% and 58%, respectively.
The incidence of sub-retinal fluid (SRF) only is 10%, intra-retinal retinal (IRF) fluid only is 14%, and SRF plus IRF is 69%
The incidence of posterior vitreous detachment (PVD), vitreo-papillary traction and vitreomacular traction (VMT) is 7%, 28% and 13%, respectively. {Meng L, Zhao X, Zhang W, Wang D, Chen Y. The characteristics of optic disc pit maculopathy and the efficacy of vitrectomy: a systematic review and meta-analysis. Acta Ophthalmol. 2021 Nov;99(7):e1176-e1189.}

2. Vitrectomy

Systematic review

2021 Meng et.al.

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2021
Systematic review

Systematic review of 59 studies on characteristics and treatment options of optic disc pit maculopathy.

The rate of complete anatomic success and visual improvement after pars plana vitrectomy are both around 85%.
Subgroup analysis reveals the anatomic, and visual success rates of PPV alone are 89% and 100%, respectively.
Gas tamponade, laser or internal limiting membrane peeling (ILMP) during vitrectomy are less promising, while PPV with ILM flap stuffing could achieve better outcomes than cases without it. {Meng L, Zhao X, Zhang W, Wang D, Chen Y. The characteristics of optic disc pit maculopathy and the efficacy of vitrectomy: a systematic review and meta-analysis. Acta Ophthalmol. 2021 Nov;99(7):e1176-e1189.}

Systematic review

2020 Zheng et.al.

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2020
Systematic review

Systematic review of 26 studies on surgical management of optic disc pit maculopathy.

6 commonly reported techniques were identified:
- PPV alone
- PPV plus juxtapapillary laser treatment (JPL)
- PPV plus internal limiting membrane peeling (ILMP)
- PPV plus both ILMP and JPL
- PPV plus inner retinal fenestration
- PPV plus autologous platelet concentrate
All groups demonstrated improved best-corrected visual acuity compared with baseline, with no differences between groups
The average OPM resolution rate was 70%, and the average time to resolution was 8.4 months for all groups
Central macular thickness was reduced in all groups with no differences between groups
Tamponade had no effect on outcomes{Zheng A, Singh RP, Lavine JA. Surgical Options and Outcomes in the Treatment of Optic Pit Maculopathy: A Meta-analysis and Systematic Review. Ophthalmol Retina. 2020 Mar;4(3):289-299.}

Review

2020 Theodossiadis et.al.

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2020
Review

Review of new treatment modalities for ODP maculopathy, specifically on covering and stuffing of the ODP.

Vitrectomy seems to be more successful if it is associated with the covering of the ODP by internal limiting membrane (ILM) inverted flapping
Another new procedure aims at the stuffing of the ODP by rolled ILM-flap, autologous scleral tissue or human amniotic membrane, providing promising anatomical results. {Theodossiadis G, Theodossiadis P, Chatziralli I. Thoughts and Challenges for the Current Treatment of Optic Disc Pit Maculopathy. Semin Ophthalmol. 2020 May 18;35(4):232-236.}

Theodossiadis et.al.
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References

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