TY - JOUR
T1 - Post-traumatic macular break associated to congenital optic disc pit and pre-existing sensory macular detachment
AU - Billi, Bernardo
AU - Lesnoni, Guido
AU - Giuliano, Mario
AU - Rossi, Tommaso
AU - Stirpe, Mario
PY - 1996
Y1 - 1996
N2 - Background. Optic disc pits represent a rare congenital abnormality frequently associated with macular detachment. Several theories on the pathogenesis of the detachment have been proposed, but the issue still remains unclear. Treatment remains speculative as well; advocated treatments include eye-patching, bed rest, steroids, laser photocoagulation, pars plana vitrectomy with fluid-air exchange and optic nerve sheath decompression. Methods. The authors report on the case of an optic pit with associated macular detachment which developed an inner layer macular hole and, after an apparently insignificant skull trauma, a large macular break. The patient underwent a standard three-port pars plana vitrectomy, fluid gas-exchange, posterior scleral buckling and laser treatment. Results. Twelve months after surgery the retina was flat, posterior buckling was evident and laser treatment pigmented. Visual acuity was 20/600. Conclusions. The presence of strands of condensed vitreous strands crossing the posterior lacuna and exerting traction over the macula and optic disc, support the theory of a possible tractional role of anomalous vitreous adhesion in the pathogenesis of the detachment and macular break. Anomalous vitreous adhesion over the posterior retina could be related to the malformative genesis of the syndrome, and the anomalous persistence of the Cloquet's canal or primary vitreous could be responsible for the traction.
AB - Background. Optic disc pits represent a rare congenital abnormality frequently associated with macular detachment. Several theories on the pathogenesis of the detachment have been proposed, but the issue still remains unclear. Treatment remains speculative as well; advocated treatments include eye-patching, bed rest, steroids, laser photocoagulation, pars plana vitrectomy with fluid-air exchange and optic nerve sheath decompression. Methods. The authors report on the case of an optic pit with associated macular detachment which developed an inner layer macular hole and, after an apparently insignificant skull trauma, a large macular break. The patient underwent a standard three-port pars plana vitrectomy, fluid gas-exchange, posterior scleral buckling and laser treatment. Results. Twelve months after surgery the retina was flat, posterior buckling was evident and laser treatment pigmented. Visual acuity was 20/600. Conclusions. The presence of strands of condensed vitreous strands crossing the posterior lacuna and exerting traction over the macula and optic disc, support the theory of a possible tractional role of anomalous vitreous adhesion in the pathogenesis of the detachment and macular break. Anomalous vitreous adhesion over the posterior retina could be related to the malformative genesis of the syndrome, and the anomalous persistence of the Cloquet's canal or primary vitreous could be responsible for the traction.
KW - macular sensory detachment
KW - optic pits
KW - traumatic macular break
KW - vitreous traction
UR - http://www.scopus.com/inward/record.url?scp=0030425306&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0030425306&partnerID=8YFLogxK
M3 - Article
C2 - 9112198
AN - SCOPUS:0030425306
VL - 20
SP - 269
EP - 272
JO - International Ophthalmology
JF - International Ophthalmology
SN - 0165-5701
IS - 5
ER -