[Treatment of macular detachment complicating optic disk coloboma pits. Long-term results of the photocoagulation-gas combination].

We managed 19 eyes of 19 patients with serous macular detachment associated with optic nerve pits with photocoagulation of the temporal edge of the optic disc combined with intravitreal injection of an expanding gas. SF6 was used in 8 eyes, and C3F8 in 11 eyes at the initial treatment. Eight eyes (42%) had repeated treatment because of failed initial treatment and/or late recurrence(s). Eighteen patients were followed up for 4 to 110 months (mean follow-up: 39 months). At the last examination the macula was attached in 17 of 18 eyes (94.4%). However 3 patients (17.6%) showed a limited serous retinal detachment distant from the macula. The results achieved after single treatment were better with C3F8 than with SF6 (78.5% versus 57% anatomical success rate). During the follow-up period, 5 eyes (27.7%) developed one or two late recurrences. Macular reattachment occurred spontaneously in 2 eyes and after repeated C3F8 injection in 3 eyes. The final visual acuity was improved by 0.1 to 0.6 as compared to the initial visual acuity in 12 patients (66.6%). Ten patients (55.5%) had a final visual acuity > or = 0.5 and > or = Parinaud scale no. 2. We believe that photocoagulation treatment combined with C3F8 intravitreal injection is a valuable approach to the management of serous macular detachment associated with optic nerve pits. However the treatment also shows limitations, in particular the need for repeated treatment in failed eyes and/or eyes with late recurrences.