Choroid Involvement Secondary to Optic Disc Pit Maculopathy: OCT Analysis and Evolution After Surgical Treatment

Purpose

To assess choroidal changes associated to optic disc pit maculopathy (ODP-M) and their evolution after surgical treatment.

Design

Multicentric retrospective case series.

Methods

An analysis of 42 patients affected by unilateral ODP-M undergoing surgical treatment between 2013 and 2023 was conducted. Optical coherence tomography (OCT) was performed at baseline and postoperative months 1, 6, 12, and 24 and most recent follow-up. Subfoveal choroidal thickness (SFCT) and peripapillary choroidal thickness (PPCT) were measured in ODP-M and fellow eyes. The presence of retinal pigmented epithelium (RPE) atrophy was used to distinguish between “early” and “advanced” disease, and data regarding fluid localization were collected.

Results

Baseline SFCT in ODP-M eyes was significantly higher than fellow eyes (386.8 ± 88.9 vs 334.4 ± 72.2 µm, P = 0.002), in contrast to PPCT (192.6 ± 47.8 vs 181.2 ± 45.7 µm, P = .46). SFCT significantly decreased 1 month postoperatively (mean reduction 36.5 µm, P = .009) and remained below preoperative values throughout the follow-up, showed a mean reduction of 79.4 µm at final follow-up (P < .001). Conversely, PPCT showed no changes between preoperative and postoperative values (all P > .05). Nine eyes (21.4%) showed submacular dilated choroidal vessels, correlated with the presence of subretinal fluid (P = .008) and reducing in caliber after surgical treatment. The 10 eyes (23.8%) with advanced disease had lower baseline SFCT and worse best-corrected visual acuity compared to the early disease subgroup, and showed a delayed reduction of choroidal swelling postoperatively.

Conclusions

Subfoveal choroid may thicken and remodel in response to ODP-M, eventually returning to physiological values after surgical treatment. Moreover, the presence of RPE atrophy may influence retino-choroidal balance. Conversely, PPCT did not show comparable modifications.