Long-term outcomes of pars plana vitrectomy without internal limiting membrane peeling for optic disc pit maculopathy R Avci 1 , S Yilmaz 1 , UU Inan 2 , B Kaderli 3 , M Kurt 1 , O Yalcinbayir 3 , M Yildiz 3 and A Yucel 3 Abstract Purpose To evaluate the results of surgical treatment of maculopathy secondary to congenital optic pit anomaly with pars plana vitrectomy (PPV), endolaser to the temporal edge of the optic disc and C3F8 tamponade without internal limiting membrane (ILM) peeling. Patients and methods Thirteen eyes of 12 patients with serous macular detachment and/or macular retinoschisis secondary to congenital optic disc pit (ODP) were included in the study. All eyes underwent PPV, posterior hyaloid removal, endolaser photocoagulation on the temporal margin of the optic disc and 12% C3F8 gas tamponade. Anatomic success and functional outcome determined retrospectively by optical coherence tomography and measurement of best corrected visual acuity (BCVA), respectively were the main outcome parameters. Results Two lines or more improvement in BCVA was obtained in 11 eyes and 6 of these eyes had 20/40 or better BCVA at the final visit. Subretinal or intraretinal fluid was completely resorbed postoperatively in 12 eyes but a little intraretinal fluid persisted in one eye at the 16-month follow-up. Better visual improvement was observed in patients treated by earlier surgical intervention. Conclusion PPV, C3F8 gas tamponade and endolaser to the optic disc margin without ILM peeling may yield favourable results in the treatment of ODP maculopathy. Eye (2013) 27, 1359–1367; doi:10.1038/eye.2013.172; published online 13 September 2013 Keywords: internal gas tamponade; laser endophotocoagulation; optical coherence tomography; optic disc pit maculopathy; pars plana vitrectomy Introduction Congenital pits of the optic nerve head are a rare clinical entity affecting o1 in 10 000 persons. 1,2 Congenital optic disc pits (ODP) are bilateral in 10–15% of patients. Serous macular detachment associated with ODP develops within the second to fourth decades of life in 25–75% of cases. 3–6 Most authors thought that macular elevation associated with ODP represented serous retinal detachment even before the era of optical coherence tomography (OCT). The typical pattern of macular schisis seen on OCT helps us to differentiate this pathology from other macular elevations. This situation is observed not only due to serous macular detachment but also due to separation within the inner layers of the retina. 2–19 Treatment of ODP associated maculopathy is somewhat controversial because there is no consensus regarding the indications for surgical intervention, or the methods and techniques of surgery. Although there are several treatment options for this pathology, none of them has been generally accepted as a choice of treatment method that is shown to be superior to the other treatment methods. 7,20–40 Macular buckle surgery and optic nerve sheath fenestration were employed in the past. 4,11,29–32 Although pars plana vitrectomy (PPV) and gas tamponade was performed at least twenty years ago, this procedure with or without inner limiting membrane (ILM) peeling has become 1 Retina Eye Hospital, Bursa, Turkey 2 Kocatepe University Medical School Department of Ophthalmology, Afyonkarahisar, Turkey 3 Uludag University Medical School Department of Ophthalmology, Bursa, Turkey Correspondence: UU Inan, Kocatepe University School of Medicine, Department of Ophthalmology, Afyon 03200, Turkey Tel: +90 272 2463301; Fax: +90 272 246 3322. E-mail: uuinan@gmail.com This study was presented in the XXVIIIth Meeting of the Club Jules Gonin, Reykjavik, Iceland, 20-23 June 2012. Received: 12 November 2012 Accepted in revised form: 15 July 2013 Published online: 13 September 2013 CLINICAL STUDY Eye (2013) 27, 1359–1367 & 2013 Macmillan Publishers Limited All rights reserved 0950-222X/13 www.nature.com/eye