Fluid Dynamics and Advanced OCT Biomarkers in Optic Disc Pit Maculopathy: Influence on Visual Outcomes

IF 4.2 1区医学 Q1 OPHTHALMOLOGY

American Journal of Ophthalmology Pub Date : 2025-06-06 DOI:10.1016/j.ajo.2025.05.050

Matteo Mario Carlà , Francesco Boselli , Federico Giannuzzi , Laura De Luca , Emanuele Crincoli , Fiammetta Catania , Gloria Gambini , Tomaso Caporossi , Carlos Mateo , Stanislao Rizzo

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引用次数: 0

Abstract

Purpose

To characterize sequential pattern of fluid progression in optic disc pit maculopathy (ODP-M), identify threshold values for fluid migration between retinal layers, and determine the prognostic significance of optical coherence tomography (OCT) biomarkers.

Design

Multicenter, retrospective interventional case series.

Methods

Forty-two eyes with ODP-M underwent surgical treatment with follow-up ≥12 months (mean 38.5 ± 30.6 months). OCT parameters including intraretinal fluid (IRF) height, foveal detachment (FD), intrapapillary proliferation (IPP), ellipsoid zone (EZ) integrity, and retinal pigment epithelium (RPE) disruption were analyzed preoperatively and at 1, 6, 12, and 24 months postoperatively. Visual and anatomical outcomes were evaluated using multivariate regression and Kaplan-Meier survival analysis.

Results

IRF followed a distinct progression pattern, sequentially involving the outer nuclear layer (ONL), inner nuclear layer (INL), and nerve fiber layer (NFL). Resolution after surgery occurred in reverse order (NFL→INL→ONL) with median resolution times of 3, 6, and 12 months, respectively. Surgical success rate after first intervention was 66.7%, with complete final fluid resolution in 72.2% of cases. ROC analysis identified threshold values for ONL→INL progression (152 µm, AUC = 0.84) and for INL→NFL progression (178 µm, AUC = 0.79). In multivariate analysis, independent predictors of final visual acuity included preoperative visual acuity (OR: 4.73, p < .001), absence of FD (OR: 0.31, p = .03), EZ visibility (OR: 0.42, p = .04), and absence of IPP (OR: 0.45, p = .05).

Conclusions

ODP-M demonstrates a predictable pattern of fluid accumulation and resolution, with specific threshold values for fluid progression between retinal layers that may guide intervention timing and preoperative OCT biomarkers providing valuable prognostic information for visual outcomes.

查看原文本刊更多论文

视盘斑坑病的流体动力学和先进OCT生物标志物：对视力结果的影响。

目的：表征视盘斑点病（ODP-M）液体进展的顺序模式，确定视网膜层间液体迁移的阈值，并确定光学相干断层扫描（OCT）生物标志物的预后意义。设计：多中心，回顾性介入病例系列。方法：手术治疗ODP-M 42眼，随访≥12个月（平均38.5±30.6个月）。术前、术后1、6、12、24个月分别分析视网膜内液（IRF）高度、中央凹脱离（FD）、乳头内增生（IPP）、椭球带（EZ）完整性、视网膜色素上皮（RPE）破坏等OCT参数。使用多变量回归和Kaplan-Meier生存分析评估视觉和解剖结果。结果：IRF具有明显的进展模式，依次累及外核层（ONL）、内核层（INL）和神经纤维层（NFL）。术后消退顺序相反（NFL→INL→ONL），中位消退时间分别为3、6、12个月。首次干预后手术成功率为66.7%，最终液体完全溶解率为72.2%。ROC分析确定了ONL→INL进展（152 μm， AUC=0.84）和INL→NFL进展（178 μm， AUC=0.79）的阈值。在多变量分析中，最终视力的独立预测因素包括术前视力（OR 4.73, p）。结论：ODP-M显示了一种可预测的液体积聚和溶解模式，视网膜层之间液体进展的特定阈值可以指导干预时机，术前OCT生物标志物为视力结果提供了有价值的预后信息。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American Journal of Ophthalmology 医学-眼科学

CiteScore

9.20

自引率

7.10%

发文量

406

审稿时长

36 days

期刊介绍： The American Journal of Ophthalmology is a peer-reviewed, scientific publication that welcomes the submission of original, previously unpublished manuscripts directed to ophthalmologists and visual science specialists describing clinical investigations, clinical observations, and clinically relevant laboratory investigations. Published monthly since 1884, the full text of the American Journal of Ophthalmology and supplementary material are also presented online at www.AJO.com and on ScienceDirect. The American Journal of Ophthalmology publishes Full-Length Articles, Perspectives, Editorials, Correspondences, Books Reports and Announcements. Brief Reports and Case Reports are no longer published. We recommend submitting Brief Reports and Case Reports to our companion publication, the American Journal of Ophthalmology Case Reports. Manuscripts are accepted with the understanding that they have not been and will not be published elsewhere substantially in any format, and that there are no ethical problems with the content or data collection. Authors may be requested to produce the data upon which the manuscript is based and to answer expeditiously any questions about the manuscript or its authors.