IMPROVEMENT IN VISUAL FUNCTION AFTER DISPLACEMENT OF THE RETINAL ELEVATIONS EMANATING FROM OPTIC PITS

Objective: To define the functional deficit that correlates with the i nner layer separation and the outer layer detachment that have been ob served in optic pit maculopathy and to determine the effect of a gas t amponade that compresses or displaces the two layers. Design: The cent ral visual field before and after a gas tamponade on the posterior pol e were charted on a 1-m tangent screen and compared with the changes i n the retina observed biomicroscopically and with stereophotography. S etting: The gas operations were done at four hospitals in the New York , NY, area and one in Cleveland, Ohio. The retinal examinations, visua l 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 be tween the ages of 18 and 46 years with optic pit maculopathy. Intorven tion: The patients were operated on by five retinal surgeons with a va riety of procedures. Four patients had a vitrectomy and intraocular ga s injected. Five patients had gas injected after external compression. Two patients had laser applied in conjunction with the intraocular in jection. The gas tamponade was the unifying factor. Results: The dense central scotoma in optic pit maculopathy relates to the outer layer d etachment and displacement of it from the posterior pole yields an imp rovement in visual acuity. The inner layer separation persists central ly 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 sep aration is mild and consistent with relatively good visual acuity.