Comparative Outcomes of Pars Plana Vitrectomy With and Without Adjunct Laser Photocoagulation in Optic Disc Pit Maculopathy.

Abstract

Purpose: Optic disc pit maculopathy (ODP-M) is a rare condition that can lead to progressive visual impairment. Although pars plana vitrectomy (PPV) has become the mainstay of treatment, the additional benefit of adjunct peripapillary laser photocoagulation remains controversial. We hypothesized that adjunct laser photocoagulation does not provide additional anatomical or functional benefit when combined with PPV and gas tamponade. This study aimed to compare the anatomical and functional outcomes of PPV with and without adjunct peripapillary endolaser photocoagulation in the management of ODP-M.

Methods: This retrospective comparative study included 19 eyes of 17 patients who underwent PPV with gas tamponade for ODP-M between January 2013 and August 2024. Patients were divided into two groups according to whether endolaser photocoagulation was applied to the temporal margin of the optic disc during surgery. Pre- and postoperative best-corrected visual acuity (BCVA), central retinal thickness (CRT), and anatomical outcomes were compared between groups. Anatomical success was defined as complete resolution of subretinal and/or intraretinal fluid on spectral-domain optical coherence tomography (SD-OCT).

Results: The mean postoperative follow-up duration was 20 months (range, 12-36 months). Anatomical success was achieved in 9 of 10 eyes (90%) in the laser group and 8 of 9 eyes (89%) in the nonlaser group (p = 1.00). The mean postoperative BCVA was 0.40 ± 0.27 logMAR and 0.41 ± 0.24 logMAR, respectively (p = 0.82). Both groups showed significant visual improvement compared to baseline, but there were no intergroup differences in BCVA or CRT changes. No intraoperative or postoperative complications such as retinal detachment, macular hole formation, or endophthalmitis were observed.

Conclusion: PPV with gas tamponade provides favorable anatomical and functional outcomes in ODP-M. The addition of endolaser photocoagulation does not yield further benefit and may be unnecessary in standard PPV-based management.