Optic disc pit maculopathy: Covering or filling technique with human amniotic membrane patch to treat the optic disc pit maculopathy?

Purpose: To describe two patients affected by optic disk pit-maculopathy ODP-M surgically treated with pars-plana vitrectomy (PPV) and the apposition of a human Amniotic Membrane (hAM) patch. Methods: Patients underwent a PPV with the apposition of a hAM patch to cover the ODP. In case 1, a 2nd surgery was necessary to push the hAM patch inside the pit, whereas in case 2 the patch was pulled inside the pit following the pressure gradient when infusion was turned on. Results: After surgery the hAM patch filled the ODP and in both cases, during follow-up, there was a progressive reduction of macular OCT changes and a concomitant BCVA improvement. Conclusion: Our experience seems to support the idea that the dynamic fluctuation of pressure between intra-ocular and intra-cranial spaces can direct the movement of fluid through the anomalous communication created by the ODP. In this perspective, our cases seem to support the idea that the primary goal of any surgery should be to create a permanent barrier to fluid migration through the ODP to the intra-ocular space, and that hAM can be successfully used to fill the OPD and to create that permanent barrier to achieve the resolution of ODP-M.