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

Figure 5

Photographs of the left eye in a 68-year-old patient with maculopathy associated with morning glory anomaly of the optic disc (case 5). (a, b) Preoperative images. Fundus photograph showed retinal detachment extending from the morning glory disc anomaly to the macula (a, arrowheads). Arrows indicate the optical coherence tomography (OCT) scan in Figure 5. A spectral domain OCT image showed retinal schisis with macular detachment and a tunnel-like hyporeflectivity extending from the retinal schisis toward the disc (b, arrowheads), suggesting a communication between the disc and retinal schisis (b). The hyaloid membrane (b, black arrow) was attached around the disc and on the epipapillary glial tissue (b, white arrow). (c) Macular detachment was reduced at 4 months after pars plana vitrectomy with epipapillary membrane removal. (d) Twelve months after surgery, an enhanced depth imaging OCT image revealed that the tunnel-like hyporeflectivity observed preoperatively was resolved with the reduction of the retinal schisis (arrowheads). (e) Fifteen months after surgery, retinal schisis was almost resolved and the optic disc cupping became deeper (arrow) than in pretreatment.

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