OPTICAL COHERENCE TOMOGRAPHY OF PNEUMATIC DISPLACEMENT OF OPTIC DISC PIT MACULOPATHY

Background-The authors have previously concluded that fluid from an op tic disc pit creates an inner layer separation (ILS) of the retina. An outer layer detachment (OLD) centred on the macula is a secondary phe nomenon that causes a dense central scotoma. Pneumatic displacement of the OLD effects an improvement in central vision. Pathology to confir m these conclusions is lacking. intraretinal images obtained by optica l coherence tomography (OCT), however, are confirmatory. Methods-Three patients with optic disc pit maculopathy were studied with stereoscop ic photographs, visual fields, and OCT before and after intravitreal g as was injected to displace the central retinal elevation to below the inferior temporal vascular arcade. Results-Preoperatively, OCT demons trated an ILS that connected with the optic disc pit. External to it w as an OLD that centred on the fovea and did not connect with the optic disc pit. Pneumatic displacement of the OLD was accompanied by an imp rovement in central vision. Long term follow up indicates that the eff ect of displacement may be temporary. Conclusion-OCT confirmed the two layer structure of optic disc pit maculopathy and that the improvemen t in central vision after pneumatic displacement coincides with a reat tachment of the OLD in the macula. It also supports the hypothesis tha t the ILS, which persists, provides a conduit for the continuous flow of fluid from the pit to the displaced retinal elevation.