Role of the Epipapillary Membrane in Maculopathy Associated with Cavitary Optic Disc Anomalies: Morphology, Surgical Outcomes, and Histopathology

Figure 1

Photographs of the right eye in a 20-year-old optic disc pit (ODP) maculopathy patient without posterior vitreous detachment (PVD) (case 1). (a, b) Findings before surgery. Fundus photograph showed an ODP (a, arrowhead) and retinal elevation at the macular area (a). An arrow indicates an enhanced depth imaging optical coherence tomography (EDI-OCT) scan for the images shown in Figure 1. An EDI-OCT image revealed retinal schisis extending from the optic disc to the macula with foveal retinal detachment (b). The posterior hyaloid membrane (b, arrowheads) was attached toward the membrane that was present on the ODP (b, arrow). (c–e) Findings during pars plana vitrectomy with epipapillary membrane removal. When PVD was intentionally made, most of the hyaloid membrane was detached from the optic disc (c, arrowheads). However, a part of the membrane connected with the glial tissue on the disc (c, arrow). After making a complete PVD, the membrane tissue that remained on the ODP was grasped using forceps (d). The glial tissue was firmly attached, penetrating the ODP (e, arrow). (f–i) Postoperative OCT images. The retinal schisis gradually was reduced (f, g) and was resolved with foveal attachment 12 months after the surgery (h). The membrane tissue on the disc was also removed (g, arrow). Fundus photograph at 15 months after surgery shows the resolution of the retinal schisis (i).

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