Refik OLTULU, İsmail ERŞAN, Günhal ŞATIRTAV, Mehmet OKKA

Seröz maküler dekolmanlı optik disk çukurluğu bulunan bir çocuk

Bu yazıda nadir görülen, seröz maküler dekolmanlı optik disk çukurluğu bulunan çocuk olguyu sunuyoruz. Optik disk çukurları 10000’de 1’den daha az görülür ve olguların %10-15’inde iki taraflıdır. Doğumsal optik disk çukuru olgularının yaklaşık %50’si seröz makula dekolmanı ile ilişkilidir. Uzun süre devam eden seröz dekolmanlar genellikle makülanın kistik dejenerasyonu ve alttaki retinal pigment epitelinden pigment kaybı ile ilişkilidir. Bundan dolayı, seröz maküla dekolmanı olan gözlerin çoğunda optik disk çukuru oluşumu ile birlikte göreceli olarak kötü görsel prognoz vardır. Burada seröz dekolmanlı optik disk çukuru olan çocuk olgunun değerlendirilmesinin klinik önemini vurguladık

Anahtar Kelimeler:

Kolobom, maküla dejenerasyonu, optik sinir, retina dekolmanı

Optic disc pit with serous macular detachment in a child

Optic disc pits occur in less than 1 in 10.000. Approximately 50% of cases of congenital optic disc pits are associated with serous macular detachment. Long-standing serous detachments are usually associated with cystic degeneration of the macula and loss of pigment from the underlying retinal pigment epithelium. Hence, most eyes with serous macular detachment associated with an optic disc pit have a relatively poor visual prognosis. We represent a 9-year-old girl with a right optic disc pit associated with serous retinal detachment of the macula. Our experience underline that clinicians must be vigilant about the assessment of optic disc pit and furthermore in the diagnosis of optic disc pit, careful and close ophthalmologic examination for macular detachment is recommended for early diagnosis.

Keywords:

Coloboma, macular degeneration, optic nerve, retinal detachment,

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Krivoy D, Gentile R, Liebmann JM, et al. Imaging congenital optic disc pits and associated maculopathy using optical co- herence tomography. Arch Ophthalmol 1996;114:165-170.
Kranenburg EW. Crater-like holes in the optic disk and cen- tral serous retinopathy. Arch Ophthalmol 1960; 64:912-924.
Brown GC, Shields JA, Goldberg RE. Congenital pits of the optic nerve head: II. Clinical studies in humans. Ophthal- mology 1980;87:51-65.
Rosenthal G, Bartz-Schmidt KU, Walter P, Heimann K. Au- tologous platelet treatments for optic disc pit associated with persistent macular detachment. Graefes Arch Clin Exp Ophthalmol 1998; 236:151-153.
Theodossiadis G, Panopoulos M, Kollia A, Georgopoulos G. Long-term study of patients with congenital pit of the optic nerve and persistent macular detachment. Acta Ophthalmol 1992;70:495-505.
Akiba J, Kakehashi A, Hikichi T, Trempe CL. Vitreous find- ings in cases of optic nerve pits and serous macular detach- ment. Am J Ophthalmol 1993;116:38-41.
Bonnet M. Serous macular detachment associated with optic nerve pits. Graefes Arch Clin Exp Ophthalmol 1991;229:526-532.
Hirakata A, Okada AA, Hida T. Long-term results of vitrecto- my without laser treatment for macular detachment associ- ated with an optic disc pit. Ophthalmology 2005;112:1430- 1435.
Theodossiadis GP. Treatment of maculopathy associated with optic disc pit by sponge explant. Am J Ophthalmol 1996; 121:630-637.
Hasegawa T, Akiba J, Ishiko S, et al. Abnormal vitreous structure in optic nerve pit. Jpn J Ophthalmol 1997;41:324- 327.
Oltulu R, Şahin A, Kerimoğlu H. Bilateral optic pit maculopathy: case report. Turkiye Klinikleri J Med Sci 2011;31:1271-1273.
Lee KJ, Peyman GA. Surgical management of retinal de- tachment associated with optic nerve pit. Int Ophthalmol 1993;17:105-107.
Snead MP, James N, Jacobs PM. Vitrectomy, argon laser, and gas tamponade for serous retinal detachment associ- ated with an optic disc pit: a case report. Br J Ophthalmol 1991;75: 381-382.
Hirakata A, Hida T, Wakabayashi T, Fukuda M. Unusual posterior hyaloid strand in a young child with optic disc pit maculopathy: intraoperative and histopathological findings. Jpn J Ophthalmol 2005; 49:264-266.
Ishikawa K, Terasaki H, Mori M, Sugita K, Miyake Y. Opti- cal coherence tomography before and after vitrectomy with internal limiting membrane removal in a child with optic disc pit maculopathy. Jpn J Ophthalmol 2005;49:411-413.
Ghosh YK, Banerjee S, Konstantinidis A, Athanasiadis I, Kirkby GR, Tyagi AK. Surgical management of optic disc pit associated maculopathy. Eur J Ophthalmol 2008;18:142- 146.
Georgalas I, Kouri A, Ladas I, Gotzaridis E. Optic disc pit maculopathy treated with vitrectomy, internal limiting membrane peeling, and air in a 5-year-old boy. Can J Oph- thalmol 2010;45:189-191.