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

Figure 6

Photographs of the right eye in a 52-year-old patient with retinoschisis associated with glaucoma without posterior vitreous detachment (case 7). (a) Fundus photographs before surgery demonstrating retinal elevation, retinal folds extending from the macula to the optic disc, and glaucomatous optic disc cupping with nerve fiber layer defect but no obvious optic disc pit. (b) Humphrey threshold 30-2 perimetry before surgery showing decreased sensitivity at the Bjerrum area. (c–f) Horizontal scan images of enhanced depth imaging optical coherence tomography. An image before surgery showed retinal schisis with foveal detachment extending from the optic disc to the macula, the epipapillary membrane (c, arrow), and a shallow tunnel-like hyporeflectivity (c, arrowheads) directly connecting the retinal schisis and the 8 o’ clock margin of the disc (c). The posterior hyaloid membrane was attached to the vicinty of the disc. Two weeks after pars plana vitrectomy, retinal schisis decreased with an obscure tunnel-like hyporeflectivity (d, arrowhead). The extent of the disc cupping was obviously deeper than preoperative one following the removal of the membrane tissue (d, arrow). Retinal schisis with macular detachment gradually decreased (d–f) and was completely resolved 18 months after surgery (f). (g) Fundus photograph showed the decrease of macular elevation at the macula but no optic disc pit at 12 months after surgery.

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