Pediatric Ophthalmology

OPTIC DISC PITS 153

● Treatment options include the following: ● Laser photocoagulation temporal to the disc area to create a barrier for fluid not to enter the macula. This approach has not had much success in most studies. ● PPV with or without internal limiting membrane (ILM) peel, with or without endo laser, and gas tamponade is the most common surgical option. ● PPV combined with inverted ILM flap to cover the optic disc and the ODP. It seems to be a good approach for the management of se rous macular detachment secondary to ODP. ● Gas tamponade injection with or without barrier laser at the temporal disc edge ● Macular buckle to promote reattachment of the macula via ab externo compression when

detachment involves the macula but techni cally challenging ● Inner retinal fenestrations to create passage for the fluid to travel to the vitreous Prognosis ● Isolated ODP has usually an excellent prognosis. ● Associated retinal complications such as se rous macular detachment can be progressive and significantly decrease visual acuity—ad vice patients about the importance of regular comprehensive eye examinations and the use of Amsler grid testing. ● Posterior macular reattachment can occur in rare instances.

FIGURE 8-3. Optic disc pit. Congenital pit of the optic nerve head.

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