2 Department of Ophthalmology, National and Kapodistrian University of Athens , Athens, Greece.
Semin Ophthalmol. 2020 May 18;35(4):232-236. doi: 10.1080/08820538.2020.1809684. Epub 2020 Aug 18.
The present review describes the procedures that intervene directly in covering and stuffing the optic disc pit (ODP).
We made a comprehensive review of the literature regarding the new treatment modalities for the treatment of ODP maculopathy, mainly concentrated on covering and stuffing of the ODP. We presented the anatomical and functional outcomes of these techniques in patients with ODP maculopathy, while potential risks and complications of these techniques are also discussed.
The most commonly used treatment alternative for ODP maculopathy is vitrectomy, which seems to be more successful if it is associated with the covering of the ODP by internal limiting membrane (ILM) inverted flapping. The results of the procedure are successful, if the origin of the fluid comes from the vitreous cavity. Another new procedure aims at the stuffing of the ODP by rolled ILM-flap, autologous scleral tissue or human amniotic membrane, providing promising anatomical results. The so far anatomical and functional results are discussed in detail. The literature, however, is limited regarding these techniques and based mainly on case reports with short-term follow-up. Additionally, the stuffing technique is possible to provoke further damage of optic nerve tissue and remain challenging in its use.
Both covering and stuffing techniques of the ODP seem to have promising results, when used as adjunct to vitrectomy. One should take into account special considerations and possible further complications for their use in the treatment of ODP maculopathy.
本综述描述了直接覆盖和填塞视盘小凹(ODP)的手术过程。
我们对治疗 ODP 黄斑病变的新治疗方法进行了全面的文献回顾,主要集中在覆盖和填塞 ODP。我们介绍了这些技术在 ODP 黄斑病变患者中的解剖学和功能结果,同时还讨论了这些技术的潜在风险和并发症。
ODP 黄斑病变最常用的治疗选择是玻璃体切除术,如果与 ODP 内界膜(ILM)反转瓣覆盖联合使用,似乎更成功。如果液体的来源是玻璃体腔,那么手术结果是成功的。另一种新的手术方法旨在通过滚动 ILM 瓣、自体巩膜组织或人羊膜填塞 ODP,提供有前景的解剖学结果。迄今为止,这些技术的解剖学和功能结果都有详细的讨论。然而,关于这些技术的文献有限,主要基于短期随访的病例报告。此外,填塞技术可能会进一步损害视神经组织,在使用时仍然具有挑战性。
覆盖和填塞 ODP 的技术似乎都有很好的效果,作为玻璃体切除术的辅助治疗方法。在治疗 ODP 黄斑病变时,应考虑到其使用的特殊注意事项和可能的进一步并发症。