TY - JOUR
T1 - Oral acetazolamide as a medical adjuvant to retinal surgery in optic disc pit maculopathy in a pediatric patient
AU - Osigian, Carla J.
AU - Gologorsky, Daniel
AU - Cavuoto, Kara M.
AU - Berrocal, Audina
AU - Villegas, Victor
N1 - Funding Information:
None.
PY - 2020/3
Y1 - 2020/3
N2 - Purpose: To describe a novel combination of surgical and medical management for the treatment of optic disc pit maculopathy. Observations: A 12-year-old obese girl with bilateral optic disc pits presented with decreased vision in the left eye (20/400). On dilated fundus examination, she was found to have a macula-involving serous retinal detachment. Pars plana vitrectomy, posterior hyaloid peel, internal limiting membrane peel, fluid-air exchange, temporal juxtapapillary endolaser, and C3F8 tamponade were performed. Postoperatively, there was persistence of subretinal fluid, so oral acetazolamide and a weight loss regimen were started. After 3 months of medical treatment, the subretinal fluid decreased significantly and visual acuity improved to 20/60. Conclusion and Importance: Currently, the mechanisms leading to optic disc pit maculopathy remain a topic of debate. As optic disc pits may provide a conduit between the subarachnoid and subretinal spaces, the reduction of intracranial pressure with the use of systemic carbonic anhydrase inhibitors may play a role in decreasing the subretinal fluid associated with select cases of optic disc pit maculopathy.
AB - Purpose: To describe a novel combination of surgical and medical management for the treatment of optic disc pit maculopathy. Observations: A 12-year-old obese girl with bilateral optic disc pits presented with decreased vision in the left eye (20/400). On dilated fundus examination, she was found to have a macula-involving serous retinal detachment. Pars plana vitrectomy, posterior hyaloid peel, internal limiting membrane peel, fluid-air exchange, temporal juxtapapillary endolaser, and C3F8 tamponade were performed. Postoperatively, there was persistence of subretinal fluid, so oral acetazolamide and a weight loss regimen were started. After 3 months of medical treatment, the subretinal fluid decreased significantly and visual acuity improved to 20/60. Conclusion and Importance: Currently, the mechanisms leading to optic disc pit maculopathy remain a topic of debate. As optic disc pits may provide a conduit between the subarachnoid and subretinal spaces, the reduction of intracranial pressure with the use of systemic carbonic anhydrase inhibitors may play a role in decreasing the subretinal fluid associated with select cases of optic disc pit maculopathy.
KW - Acetazolamide
KW - Intracranial pressure
KW - Optic disc pit
KW - Optical coherence tomography
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U2 - 10.1016/j.ajoc.2020.100599
DO - 10.1016/j.ajoc.2020.100599
M3 - Article
AN - SCOPUS:85078039307
VL - 17
JO - American Journal of Ophthalmology Case Reports
JF - American Journal of Ophthalmology Case Reports
SN - 2451-9936
M1 - 100599
ER -