Matteo Mario Carlà , Francesco Boselli , Federico Giannuzzi , Emanuele Crincoli , Tomaso Caporossi , Carlos Mateo , Stanislao Rizzo
{"title":"继发于视盘凹陷性黄斑病变的脉络膜受累:OCT分析和手术治疗后的演变:视盘凹陷黄斑病变中的脉络膜受累。","authors":"Matteo Mario Carlà , Francesco Boselli , Federico Giannuzzi , Emanuele Crincoli , Tomaso Caporossi , Carlos Mateo , Stanislao Rizzo","doi":"10.1016/j.ajo.2024.09.022","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><div>To assess choroidal changes associated to optic disc pit maculopathy (ODP-M) and their evolution after surgical treatment.</div></div><div><h3>Design</h3><div>Multicentric retrospective case series.</div></div><div><h3>Methods</h3><div>An analysis of 42 patients affected by unilateral ODP-M undergoing surgical treatment between 2013 and 2023 was conducted. Optical coherence tomography (OCT) was performed at baseline and postoperative months 1, 6, 12, and 24 and most recent follow-up. Subfoveal choroidal thickness (SFCT) and peripapillary choroidal thickness (PPCT) were measured in ODP-M and fellow eyes. The presence of retinal pigmented epithelium (RPE) atrophy was used to distinguish between “early” and “advanced” disease, and data regarding fluid localization were collected.</div></div><div><h3>Results</h3><div>Baseline SFCT in ODP-M eyes was significantly higher than fellow eyes (386.8 ± 88.9 vs 334.4 ± 72.2 µm, <em>P</em> = 0.002), in contrast to PPCT (192.6 ± 47.8 vs 181.2 ± 45.7 µm, <em>P</em> = .46). SFCT significantly decreased 1 month postoperatively (mean reduction 36.5 µm, <em>P</em> = .009) and remained below preoperative values throughout the follow-up, showed a mean reduction of 79.4 µm at final follow-up (<em>P</em> < .001). Conversely, PPCT showed no changes between preoperative and postoperative values (all <em>P</em> > .05). Nine eyes (21.4%) showed submacular dilated choroidal vessels, correlated with the presence of subretinal fluid (<em>P</em> = .008) and reducing in caliber after surgical treatment. The 10 eyes (23.8%) with advanced disease had lower baseline SFCT and worse best-corrected visual acuity compared to the early disease subgroup, and showed a delayed reduction of choroidal swelling postoperatively.</div></div><div><h3>Conclusions</h3><div>Subfoveal choroid may thicken and remodel in response to ODP-M, eventually returning to physiological values after surgical treatment. Moreover, the presence of RPE atrophy may influence retino-choroidal balance. Conversely, PPCT did not show comparable modifications.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"270 ","pages":"Pages 120-130"},"PeriodicalIF":4.1000,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Choroid Involvement Secondary to Optic Disc Pit Maculopathy: OCT Analysis and Evolution After Surgical Treatment\",\"authors\":\"Matteo Mario Carlà , Francesco Boselli , Federico Giannuzzi , Emanuele Crincoli , Tomaso Caporossi , Carlos Mateo , Stanislao Rizzo\",\"doi\":\"10.1016/j.ajo.2024.09.022\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Purpose</h3><div>To assess choroidal changes associated to optic disc pit maculopathy (ODP-M) and their evolution after surgical treatment.</div></div><div><h3>Design</h3><div>Multicentric retrospective case series.</div></div><div><h3>Methods</h3><div>An analysis of 42 patients affected by unilateral ODP-M undergoing surgical treatment between 2013 and 2023 was conducted. Optical coherence tomography (OCT) was performed at baseline and postoperative months 1, 6, 12, and 24 and most recent follow-up. Subfoveal choroidal thickness (SFCT) and peripapillary choroidal thickness (PPCT) were measured in ODP-M and fellow eyes. The presence of retinal pigmented epithelium (RPE) atrophy was used to distinguish between “early” and “advanced” disease, and data regarding fluid localization were collected.</div></div><div><h3>Results</h3><div>Baseline SFCT in ODP-M eyes was significantly higher than fellow eyes (386.8 ± 88.9 vs 334.4 ± 72.2 µm, <em>P</em> = 0.002), in contrast to PPCT (192.6 ± 47.8 vs 181.2 ± 45.7 µm, <em>P</em> = .46). SFCT significantly decreased 1 month postoperatively (mean reduction 36.5 µm, <em>P</em> = .009) and remained below preoperative values throughout the follow-up, showed a mean reduction of 79.4 µm at final follow-up (<em>P</em> < .001). Conversely, PPCT showed no changes between preoperative and postoperative values (all <em>P</em> > .05). Nine eyes (21.4%) showed submacular dilated choroidal vessels, correlated with the presence of subretinal fluid (<em>P</em> = .008) and reducing in caliber after surgical treatment. The 10 eyes (23.8%) with advanced disease had lower baseline SFCT and worse best-corrected visual acuity compared to the early disease subgroup, and showed a delayed reduction of choroidal swelling postoperatively.</div></div><div><h3>Conclusions</h3><div>Subfoveal choroid may thicken and remodel in response to ODP-M, eventually returning to physiological values after surgical treatment. Moreover, the presence of RPE atrophy may influence retino-choroidal balance. Conversely, PPCT did not show comparable modifications.</div></div>\",\"PeriodicalId\":7568,\"journal\":{\"name\":\"American Journal of Ophthalmology\",\"volume\":\"270 \",\"pages\":\"Pages 120-130\"},\"PeriodicalIF\":4.1000,\"publicationDate\":\"2024-09-27\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"American Journal of Ophthalmology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0002939424004495\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"OPHTHALMOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Ophthalmology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0002939424004495","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
Choroid Involvement Secondary to Optic Disc Pit Maculopathy: OCT Analysis and Evolution After Surgical Treatment
Purpose
To assess choroidal changes associated to optic disc pit maculopathy (ODP-M) and their evolution after surgical treatment.
Design
Multicentric retrospective case series.
Methods
An analysis of 42 patients affected by unilateral ODP-M undergoing surgical treatment between 2013 and 2023 was conducted. Optical coherence tomography (OCT) was performed at baseline and postoperative months 1, 6, 12, and 24 and most recent follow-up. Subfoveal choroidal thickness (SFCT) and peripapillary choroidal thickness (PPCT) were measured in ODP-M and fellow eyes. The presence of retinal pigmented epithelium (RPE) atrophy was used to distinguish between “early” and “advanced” disease, and data regarding fluid localization were collected.
Results
Baseline SFCT in ODP-M eyes was significantly higher than fellow eyes (386.8 ± 88.9 vs 334.4 ± 72.2 µm, P = 0.002), in contrast to PPCT (192.6 ± 47.8 vs 181.2 ± 45.7 µm, P = .46). SFCT significantly decreased 1 month postoperatively (mean reduction 36.5 µm, P = .009) and remained below preoperative values throughout the follow-up, showed a mean reduction of 79.4 µm at final follow-up (P < .001). Conversely, PPCT showed no changes between preoperative and postoperative values (all P > .05). Nine eyes (21.4%) showed submacular dilated choroidal vessels, correlated with the presence of subretinal fluid (P = .008) and reducing in caliber after surgical treatment. The 10 eyes (23.8%) with advanced disease had lower baseline SFCT and worse best-corrected visual acuity compared to the early disease subgroup, and showed a delayed reduction of choroidal swelling postoperatively.
Conclusions
Subfoveal choroid may thicken and remodel in response to ODP-M, eventually returning to physiological values after surgical treatment. Moreover, the presence of RPE atrophy may influence retino-choroidal balance. Conversely, PPCT did not show comparable modifications.
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.
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