Laser photocoagulation or endolaser combined with vitrectomy for congenital optic disc pit maculopathy:"dam sign" of optical coherence tomography is a sign to indicate the anatomic success / 中华眼底病杂志

ABSTRACT

Objective To investigate the successful signs of laser photocoagulation or endolaser combined vitrectomy for congenital optic disc pit (ODP) with serous macular detachment.Methods A retrospective case analysis.Twelve eyes of 12 patients with congenital ODP complicated with serous macular detachment diagnosed in Zhongshan Ophthalmic Center from 2003 to 2018 were included in this study.There were 2 males (2 eyes) and 8 females (8 eyes).The average age was 30.17 years old.Retinal laser photocoagulation and/or vitrectomy were performed in all the eyes.The optic disc and macular area were scanned using the tracking mode of the Germany Heidelberg Spectralis OCT instrument.The "dam-sign" change was a retinal choroidal scar on the channel between the ODP and the macula on the OCT image after treatment.The eyes were divided into a "dam-sign" change group (group A,10 eyes) and no "dam-sign" change group (group B,2 eyes).The BCVA of eyes in group A was 0.03-0.6.In group A,1 eye was treated with laser photocoagulation alone,9 eyes were treated with vitrectomy combined with laser photocoagulation.The BCVA of eyes in group B was 0.1.All the eyes in group B underwent vitrectomy combined with laser photocoagulation.The follow-up was ranged from 6 to 174 months.The same equipment and method before treatment were used for 1,3,6,12,18,and 24 months after treatment.The BCVA,absorption of subretinal fluid (SRF) and the formation of"dam-sign" change were observed.Results At the last follow-up,the BCVA of eyes in group A was 0.4-1.0 (0.4 in 1 eye,0.5 in 3 eyes,0.6 in 2 eyes,0.8 in 3 eyes,1.0 in 1 eye).In 9 eyes treated with vitrectomy combined with laser photocoagulation,SRF was completely absorbed.In 1 eye treated with laser photocoagulation alone,SRF remained in small amount.The BCVA of the two eyes in group B was 0.03 and 0.3,respectively;and SRF was not absorbed in both of them.Conclusions The "dam-sign" change near optic disc after laser photocoagulation can promote SRF absorption and improve BCVA.It can be used as a success indicator after treatment.