Autologous platelet concentrate in surgery for macular detachment associated with congenital optic disc pit
Authors Nadal J, Suarez Figueroa M, Carreras E, Pujol P, Canut MI, Barraquer RI
Received 31 January 2015
Accepted for publication 18 April 2015
Published 22 October 2015 Volume 2015:9 Pages 1965—1971
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 4
Editor who approved publication: Dr Scott Fraser
Jeroni Nadal,1,2 Marta S Figueroa,3 Elisa Carreras,2,4 Patricia Pujol,2,4 Maria Isabel Canut,2,4,5 Rafael Ignacio Barraquer2,6
1Vitreoretinal Surgery Department at Centro de Oftalmología Barraquer, 2Universitat autónoma de Barcelona, Barcelona, 3Vissum Madrid, Madrid, 4Instituto Barraquer, 5Glaucoma Department at Centro de Oftalmología Barraquer, 6Cornea and Cataract Surgery Department at Centro de Oftalmología Barraquer, Barcelona, Spain
Purpose: To evaluate the anatomical and functional results obtained with pars plana vitrectomy (PPV) plus autologous platelet concentrate (APC) as a treatment for macular detachment associated with optic disc pit (ODP).
Methods: We performed a prospective interventional study of 19 eyes of 19 consecutive patients with posterior macular detachment due to ODP. All patients underwent PPV, posterior hyaloid peeling, fluid–air exchange, injection of 0.05 mL of APC over the ODP and 15% perfluoropropane (C3F8) endotamponade. Postoperative measures included face-up positioning for 2 hours and then avoidance of the face-up position during the ensuing 10 days. All patients underwent complete ophthalmologic examination and optical coherence tomography preoperatively at 1 month, 3 months, 6 months, 9 months, and 12 months postoperatively and then annually. Outcome measures were best corrected visual acuity (BCVA) by logMAR, improvement of quality of vision, macular attachment, and resolution of intraretinal schisis-like separation.
Results: Preoperatively, the median BCVA was 0.70 (range: 0.30–1.70) and all patients showed improved visual acuity after surgery; BCVA was 0.22 (range: 0.07–0.52) at 12 months follow-up. All patients showed complete reabsorption of intraretinal fluid (median time: 3.5 months [range: 2–8 months]) and macular attachment at the end of follow-up (median: 60 months [range: 12–144 months]), with stable or improved visual acuity. No reoperations were needed and no major adverse events were recorded.
Conclusion: For macular detachment associated with ODP, the combination of PPV, posterior hyaloid peeling, APC, and C3F8 tamponade is a highly effective alternative technique with stable anatomical and functional results.
Keywords: macular detachment, optic disc pit, maculopathy, retinoschisis, pars plana vitrectomy, autologous platelet concentrate
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