Inverted ILM Flap Technique in Optic Disc Pit Maculopathy

Ali Tavallali; Yasaman Sadeghi; Seyed-Hossein Abtahi; Hosein Nouri; Sanam Samadikhadem; Mitra Rezaei; Mehdi Mazloumi

doi:10.18502/jovr.v18i2.13189

Inverted ILM Flap Technique in Optic Disc Pit Maculopathy

J Ophthalmic Vis Res. 2023 Apr 19;18(2):230-239. doi: 10.18502/jovr.v18i2.13189. eCollection 2023 Apr-Jun.

Authors

Ali Tavallali¹, Yasaman Sadeghi², Seyed-Hossein Abtahi^{3

4}, Hosein Nouri^{3

5}, Sanam Samadikhadem^{1

2

3

4

5

6

7

8}, Mitra Rezaei^{6

7}, Mehdi Mazloumi⁸

Affiliations

¹ Private Practice, Shiraz, Iran.
² Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
³ Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
⁴ Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
⁵ School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
⁶ Department of Ophthalmology, Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
⁷ School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
⁸ Eye Research Center, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.

Abstract

Purpose: To present the outcome of optic disc pit maculopathy (ODPM) managed successfully with an inverted internal limiting membrane (ILM) flap over the optic disc. A narrative review of ODPM pathogenesis and surgical management techniques are also provided.

Case report: This prospective interventional case series included three eyes of three adult patients (25-39 years old) with unilateral ODPM and a mean duration of unilaterally decreased visual acuity of 7.33 $\pm$ 2.40 months (4-12 months). The pars plana vitrectomy with posterior vitreous detachment induction was performed on eyes, followed by an inverted ILM flap insertion over the optic disc and gas tamponade. Patients were followed for 7-16 weeks postoperatively; best-corrected visual acuity (BCVA) improved dramatically in one patient from 2/200 to 20/25. BCVA in other patients improved two and three lines - to 20/50 and 20/30, respectively. A significant anatomical improvement was achieved in all three eyes, and no complication was detected throughout the follow-up period.

Conclusion: Vitrectomy with inverted ILM flap insertion over the optic disc is safe and can yield favorable anatomical improvement in patients with ODPM.

Keywords: Internal Limiting Membrane; Macular Schisis; Optic Disc Pit Maculopathy; Optical Coherence Tomography; Serous Macular Detachment; Flap.

Publication types

Case Reports