Rose Li, BMSc '24, MSc Candidate
Rose Li
Project Title
Optimizing Treatment for Optic Disc Pit Maculopathy: A Systematic Review and Meta-Analysis
-Project supervised by Dr. Monali S. Malvankar-Mehta, PhD and completed in 2024
Abstract
Objective: To optimize optic disc pit maculopathy (ODP-M) treatment by evaluating changes in visual acuity (VA), success rates, and changes in central macular thickness (CMT) among various ODP-M interventions.
Background: Optic disc pit maculopathy (ODP-M) is a rare, congenital disorder characterized by a cavitary anomaly of the optic nerve head and intraretinal fluid and subretinal fluid in the macula. In-depth explorations of treatment interventions are valuable in optimizing patient outcomes and preventing significant vision loss. Amongst treatments, PPV is the most widely recognized and often used in combination with other treatments. However, treatment interventions have not been evaluated comprehensively against one another, resulting in the lack of consensus over the efficacy of treatment interventions.
Data and Methods: Databases including MEDLINE, EMBASE, CINAHL, ClinicalTrials.gov, and ProQuest Dissertations and Theses were searched up to November 2023. Screening followed by risk of bias assessment and data extraction was conducted. Covidence software was used to conduct the systematic review. Meta-analysis was performed using STATA v. 18.0. Heterogeneity was determined using the I2 statistics, Z-value, and χ2 statistics. Fixed-effect and random-effect models were developed based on heterogeneity.
Results: This study included 28 studies. Pars plana vitrectomy (PPV) treatments alone or with adjunctive treatments but without laser photocoagulation or internal limiting membrane (ILM) peeling treatments had a standard mean difference (SMD) of 0.53 (95% CI [-0.24–1.30]), indicating a non-significant effect in improving VA. It had a significant effect on improving CMT with an SMD of 3.26 (95% CI [1.52–5.00]). PPV treatments with laser photocoagulation and adjunctive treatments had a significant effect on improving both VA and CMT, with an SMD of 0.88 (95% CI [0.54–1.22]) and 2.36 (95% CI [1.78–2.94]) respectively. PPV treatments with ILM peeling or other similar treatments, and adjunctive treatments without laser photocoagulation had a significant effect on improving VA and CMT, with an SMD of 0.82 (95% CI [0.44–1.30]) and 2.58 (95% CI [1.82–3.34]) respectively. Most treatment strategies had high success rates.
Conclusion: ODP-M is a congenital ocular disease with no standard treatment strategy. Based on available evidence, PPV with laser photocoagulation, or PPV with ILM peeling or any similar treatments to ILM peeling, is most effective for treating ODP-M.
About Rose
Rose Li, BMSc '24, completed her Year 4 Research Project supervised by Dr. Monali Malvankar in the Department of Epidemiology and Biostatistics. She is currently an MPH candidate at the University of Toronto.
