ย 

Pit to fluid!


๐—ข๐—ฝ๐˜๐—ถ๐—ฐ ๐——๐—ถ๐˜€๐—ฐ ๐—ฃ๐—ถ๐˜ ๐— ๐—ฎ๐—ฐ๐˜‚๐—น๐—ผ๐—ฝ๐—ฎ๐˜๐—ต๐˜†โฃ

โฃ

Macular changes that occur secondary to optic disc pit include intraretinal and subretinal fluid accumulationโฃ

Occurs in 25-75%โฃ

Usually occurs at 30-40 years of ageโฃ

More common when the pit is located temporally โฃ




โฃ

๐˜๐˜ฐ๐˜ถ๐˜ณ ๐˜ฑ๐˜ฐ๐˜ด๐˜ด๐˜ช๐˜ฃ๐˜ญ๐˜ฆ ๐˜ด๐˜ฐ๐˜ถ๐˜ณ๐˜ค๐˜ฆ๐˜ด ๐˜ง๐˜ฐ๐˜ณ ๐˜ต๐˜ฉ๐˜ฆ ๐˜ง๐˜ญ๐˜ถ๐˜ช๐˜ฅ:โฃ

โฃ

1. Vitreousโฃ

2. Cerebrospinal fluid through the defectโฃ

3. Leakage from blood vessels at the pitโฃ

4. Choroid through the Bruchโ€™s membrane and peripapillary atrophyโฃ

โฃ

๐˜—๐˜ข๐˜ต๐˜ฉ๐˜ฐ๐˜ฑ๐˜ฉ๐˜บ๐˜ด๐˜ช๐˜ฐ๐˜ญ๐˜ฐ๐˜จ๐˜บ ๐˜ช๐˜ด ๐˜ค๐˜ฐ๐˜ฏ๐˜ต๐˜ณ๐˜ฐ๐˜ท๐˜ฆ๐˜ณ๐˜ด๐˜ช๐˜ข๐˜ญ:โฃ

โฃ

1. Vitreous tractionโฃ

2. Pressure gradients within the eye cause migration of fluid from the vitreous into theโฃ

subretinal spaceโฃ

โฃ

โฃ

๐˜š๐˜ฆ๐˜ฒ๐˜ถ๐˜ฆ๐˜ฏ๐˜ค๐˜ฆ ๐˜ฐ๐˜ง ๐˜ณ๐˜ฆ๐˜ต๐˜ช๐˜ฏ๐˜ข๐˜ญ ๐˜ง๐˜ญ๐˜ถ๐˜ช๐˜ฅ ๐˜ข๐˜ค๐˜ค๐˜ถ๐˜ฎ๐˜ถ๐˜ญ๐˜ข๐˜ต๐˜ช๐˜ฐ๐˜ฏ ๐˜ข๐˜ฏ๐˜ฅ ๐˜ฑ๐˜ณ๐˜ฐ๐˜จ๐˜ณ๐˜ฆ๐˜ด๐˜ด๐˜ช๐˜ฐ๐˜ฏ:โฃ

โฃ

1. Fluid from the pit creates a schisis-like inner retinal separation, associated with a mild centrocecal scotomaโฃ

2. Then, an outer layer macular hole develops beneath the inner layer, associated with a dense central scotomaโฃ

3. The fluid then dissects subretinally creating an outer retinal detachment.โฃ

4. OCT also supports the concept that the fluid first enters the inner retinal layers and onlyโฃ later makes its way to the subretinal spaceโฃ

5. It has been suggested that as fluid accumulates intraretinally and a pressure gradient isโฃ formed that is directing it into the retina and to the subretinal spaceโฃ

โฃ

๐˜›๐˜ณ๐˜ฆ๐˜ข๐˜ต๐˜ฎ๐˜ฆ๐˜ฏ๐˜ต:โฃ

โฃ

1. Observe upto 3 months for spontaneous resolution which can occur in 25% of the casesโฃ

2. Laser photocoagulation to temporal margin of the disc- laser scars will create aโฃ

chorioretinal adhesion which will act as a barrier between the ODP and the subretinalโฃ

spaceโฃ

3. Pars plana vitrectomy with induction of PVD and gas tamponade, ILM peeling is done by some surgeonsโฃ

4. Macular bucklingโฃ

โฃ

www.ophthalmobytes.comโฃ

โฃ

Image from Rajan Eye Care Hospitalโฃ

1. Optic disc pit

2. Fluid at the macula


#ophthalmology #ophthal #doctor #health #medical #vision #education #optometry #medicalstudent #optometrist #medicine #eye #ophtho #ophthalmologist #med #medicaleducation #ophthalmologyresident #oftalmologia #surgery #surgeon #opticdisc #optician #retina


Reference: https://doi.org/10.1186/s40942-015-0013-8

72 views0 comments

Recent Posts

See All
ย