Efficacy of inverted internal limiting membrane flap for treating optic disc pit maculopathy

Optic disc pit maculopathy is a serious complication of congenital optic disc pits, often resulting in significant vision loss due to intraretinal and subretinal fluid accumulation. This case report describes a 35-year-old woman with progressive visual decline in her right eye. Examination revealed optic disc pit maculopathy with marked central foveal thickness (634 μm) and a best-corrected visual acuity of 20/100. The patient underwent pars plana vitrectomy, induction of posterior vitreous detachment, selective internal limiting membrane peeling to create a temporal flap, inversion of the flap over the optic disc pit, and gas tamponade with 25% sulfur hexafluoride. At 8 months postoperatively, there was complete resolution of retinal fluid, reduction in central foveal thickness to 261 μm, and best-corrected visual acuity improved to 20/20. These anatomical and functional gains were maintained at 16 months, highlighting the efficacy and safety of the inverted ILM flap technique in optic disc pit maculopathy management.