Delayed Occurrence of Subretinal Silicone Oil after Retinal Detachment Surgery in an Optic Disc Pit – a Case Report

 

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Background

Optic disc pits are congenital depressions of the optic nerve head. Unless discovered on routine examination, pits are typically diagnosed following visual deterioration caused by serous macular detachment.

Approximately 50 % of cases of congenital optic disc pits are associated with serous macular detachment [2]. Although spontaneous resolution of the serous detachment with visual recovery can occur within a short period of onset [10] long-standing serous detachments (over one year) are usually associated with poor visual outcome because of the retinal pigment epithelial alterations and possible outer-retinal damage associated with longstanding detachments [2] [9].

The use of laser therapy alone to produce a barrier of chorioretinal adhesions at the optic disc border is often unsuccessful and repeated treatments are needed [1] [4].

Pars plana vitrectomy combined with posterior hyaloid peeling, intraocular gas/silicone oil tamponade and laser treatment to the temporal margin of the optic disc across the papillomacular bundle is much more successful. Ghosh et al reported on 7 cases with successful resorption of subretinal fluid and increase in visual acuity, but 4 of them needed a second intervention to achieve resolution [5]. Migration of gas or silicone oil into the subretinal space has been reported [6]. There is one previously published report of a delayed sequential occurrence of subretinal silicone oil in patients with an optic disc pit [3]. We present a similar case, illustrated by photographs and optical coherence tomography (OCT).

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Dr. Alex P. Lange

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