Private Retina Service, University of Buenos Aires, Buenos Aires, Argentina.
Department of Ophthalmology, University of Leipzig, Leipzig, Germany.
Retina. 2019 Nov;39(11):2161-2166. doi: 10.1097/IAE.0000000000002270.
To report a cohort with optic disk pit maculopathy (ODPM) presenting with neurosensory macular detachment that were initially misdiagnosed and mistreated; and to describe structural features on spectral domain optical coherence tomography in misdiagnosed and all other consecutive cases of ODPM.
Multicenter international retrospective cohort study.
59 eyes from 59 patients with ODPM.
Fifteen patients (25.4%) with ODPM were correctly diagnosed initially and those were significantly younger than misdiagnosed cases (age 33.8 ± 15.2 vs. 58.7 ± 15.8 years, P < 0.0001). Forty of forty-four misdiagnosed eyes (90.9%) were treated for their presumed diagnosis before referral. Eyes with initial misdiagnosis had significantly more outer retinoschisis at baseline (88.4 vs. 40.0%, P = 0.0002) and more retinal pigment epithelium alterations (90.0 vs. 27.3%, P < 0.0001) 6 months after proper treatment.
Optic disk pit maculopathy is an underdiagnosed entity and can mimic other causes for subretinal fluid. Awareness and identification of pertinent spectral domain optical coherence tomography features can help avoid inappropriate and delayed treatment.
报告一组以神经感觉性黄斑脱离为表现的视盘小凹黄斑病变（ODPM）患者，这些患者最初被误诊和误治，并描述误诊和所有其他连续的 ODPM 病例的光谱域光学相干断层扫描（SD-OCT）的结构特征。
多中心国际回顾性队列研究。
59 例 59 眼 ODPM 患者。
1）ODPM 患者中最初被误诊、诊断不准确和治疗不当的比例。2）SD-OCT 的形态学特征：视网膜下和/或视网膜内液体的其他原因、内/外视网膜劈裂、与视盘小凹的连通以及视网膜色素上皮改变。3）适当治疗 6 个月后的视力和解剖学结果。
15 例（25.4%）ODPM 患者最初被正确诊断，且这些患者明显比误诊患者年轻（年龄 33.8 ± 15.2 岁 vs. 58.7 ± 15.8 岁，P < 0.0001）。44 例误诊患者中的 40 例（90.9%）在转诊前根据其假定诊断进行了治疗。最初误诊的眼在基线时有更显著的外层视网膜劈裂（88.4% vs. 40.0%，P = 0.0002）和更多的视网膜色素上皮改变（90.0% vs. 27.3%，P < 0.0001），在适当治疗后 6 个月。
视盘小凹黄斑病变是一种被低估的疾病，可能会模仿其他导致视网膜下液的原因。对相关 SD-OCT 特征的认识和识别有助于避免不适当和延迟的治疗。
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