Inverted ILM Flap technique for Optic disk pit maculopathy скачать в хорошем качестве

Inverted ILM Flap technique for Optic disk pit maculopathy

This is a video shared by Dr. Fernando Gadelha from João Pessoa, Brazil In this video we discuss a case of a 25 yo male patient complaining of decreased vision in his left eye in the last 8 months. The Best corrected visual acuity in the right eye was 20/20 and in the left eye was 20/400. In the fundoscopy it was possible to see a gray round depression in the inferotemporal region of the optic disc associated with a serous retinal detachment involving macula in the left eye. In the OCT scans it was possible to see the vitreous attachment to the optic nerve head and the presence of a dense fibrous tissue attached to the optic disk area. Furthermore, the patient had an intraretinal and subretinal fluid and macular schisis. The pathogenesis of the optic disk pit is not fully understood and there is no consensus regarding their treatment. However, studies have shown promising long-term results in both retinal reattachment and visual improvement with pars plana vitrectomy. The key step of the vitrectomy is to remove the dense fibrous tissue around the optic disk and the role of gas tamponade, endolaser, ILM peeling or other adjuncts is still unknown. In this case, the surgeon used triamcinolone to stain the vitreous and to facilitate the PVD induction. Brilliant blue dye is used to stain the internal limiting membrane and the inverted ILM flap technique was performed. The postoperative follow-up showed a great anatomical result over 14 months with improvement of the visual acuity to 20/60 in the left eye. The retinal sensitivity in the microperimetry evaluation showed improvement also, as soon as the intra and subretinal fluid were absorbed. Vídeo: Fernando Gadelha, PhD João Pessoa 🇧🇷 Edition: Filipe Lucatto, MD Juliana Prazeres, MD Salvador 🇧🇷