Purpose: To present rapid and safe closure of the pit-macula communication (PMC) by core vitrectomy and adequate duration gas tamponade as our preferred method of resolving optic disc pit (ODP) maculopathy and to define the term “maculoschisis” in ODP maculopathy as an alternative to the term “schisis-like.” Patient and methods: A twenty-four-year-old female presented with an optical coherence tomography (OCT) confirmed ODP and a “giant” communicating maculoschisis cavity. Central macular thickness (CMT) measured 906 microns, and macular volume was twice normal, at 20.8 mmsup3/sup. Snellen corrected visual acuity was 20/70. Two months after initial vitrectomy performed elsewhere with short-term gas tamponade (SFsub6/sub 20%), CMT and visual acuity were not significantly improved. Combined lens extraction/intraocular lens placement and repeat vitrectomy with Csub3/subFsub8/sub 15% gas tamponade were performed, with one supplemental (office) gas injection. Results: OCT imaging six weeks postoperatively showed definitive closure of the PMC with CMT reduced by 405 microns. Sequestered from its ODP source, foveal schisis fluid then resolved by 12 weeks postoperatively. At final follow-up 3.4 years postoperatively, the macula remained dry with a CMT of 322 microns and a concave foveal contour. Macular volume was reduced to (a normal) 10.2 mmsup3/sup and visual acuity had improved to 20/25. Conclusion: No report heretofore has documented rapid, sustained closure of the PMC by gas tamponade as the preferred method of expeditiously resolving ODP maculopathy. However, tamponade PMC closure sequesters ODP fluid and uniquely provides early assurance of ultimate maculopathy resolution. In all other techniques, PMC closure is a trailing phenomenon and success remains uncertain during months to a year or more of (unsequestered) fluid resolution. We suggest that more invasive techniques (laser barrier application to the peripapillary choroid, vitreoretinal interface maneuvers, and pit-plugging) be withheld unless a recurrence is detected during subsequent examinations.
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机译：目的：介绍通过玻璃体玻璃体切除术和足够长的气填塞来快速，安全地关闭黄斑-丘疹相通（PMC），作为我们解决视盘凹痕（ODP）黄斑病的首选方法，并将ODP黄斑病中的“毛刺病”定义为术语和类似“裂殖体”的替代方法。患者和方法：一名24岁女性，进行了光学相干断层扫描（OCT），证实了ODP和“巨大”的沟通性黄斑内陷腔。黄斑中央厚度（CMT）为906微米，黄斑体积为20.8 mm 3 的两倍。 Snellen矫正的视力为20/70。在其他地方进行了短期气体填塞（SF 6 20％）的玻璃体切除术后两个月，CMT和视敏度没有明显改善。联合晶状体摘除/人工晶状体植入，并用C 3 F 8 15％气体填塞术重复玻璃体切除术，并进行一次补充（办公室）气体注入。结果：术后六周的OCT影像显示PMC的确定性闭合，CMT减小了405微米。从其ODP源隔离，然后在手术后12周将黄斑裂隙液分离。在术后3.4年的最后随访中，黄斑保持干燥，CMT为322微米，凹凹轮廓。黄斑体积减少到（正常）10.2 mm 3 ，视力提高到20/25。结论：迄今为止，尚无文献报道用填塞气塞快速，持续地封闭PMC，作为快速解决ODP黄斑病的首选方法。但是，填塞剂PMC封闭可隔离ODP液，并独特地为最终的黄斑病变消退提供了早期保证。在所有其他技术中，PMC闭合是一种拖尾现象，在几个月至一年或更长时间的（无约束的）流体分辨率方面，成功的成因仍然不确定。我们建议，除非在随后的检查中发现复发，否则应禁止采用更具侵入性的技术（对周围的脉络膜脉络膜，玻璃体视网膜界面操纵和凹坑堵塞应用激光屏障）。
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