Optic Pit Maculopathy: Adjunctive Treatment Using Oral Spironolactone and Topical Dorzolamide
Bibliographic record
Abstract
PURPOSE: There is no consensus for the treatment of optic disc pit maculopathy (ODPM). We describe a case of ODPM refractory to vitrectomy that was successfully treated with systemic spironolactone and topical dorzolamide 2%. METHODS: Case report. RESULTS: A 27-year-old male was referred for decreased vision in the right eye secondary to macular edema. Fundus examination and optical coherence tomography imaging revealed an optic pit maculopathy with significant macular schisis and intraretinal fluid. After an initial observation period, we performed pars plana vitrectomy with internal limiting membrane peeling, fibrin glue, and gas endotamponade. At the 2 months postoperative follow-up, anatomic and functional outcomes remained unimproved. Oral spironolactone and topical dorzolamide 2% were, therefore, added. Significant reduction in the intraretinal fluid and macular schisis was demonstrated at the last follow-up 2 years postoperative. CONCLUSION: The mechanisms underlying optic disc pit maculopathy remain controversial, and treatment guidelines are unclear. To our knowledge, this is the first description of an OPDM treated with a combination systemic mineralocorticoid receptor antagonist and topical carbonic anhydrase inhibitor as adjuvant therapy to vitrectomy with favorable outcomes. We also review the literature and propose mechanisms through which these treatment entities may act.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".