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We report Meier's syndrome in two sisters, with combined macular pseudocoloboma and end-stage renal failure. The two sisters, aged 12 and 17 years, presented with a bilateral macular coloboma and slight myopic shift reducing visual acuity to 20/60 in one sibling and 20/100 in the other sibling. No other ocular abnormalities were present. The electroretinograms were normal. In both patients renal grafts were performed with good results. The mother and the 4 other siblings were unaffected. This observation underlines the need to check kidney function in case of bilateral pseudocoloboma.

Purpose: Etiopathogeny of serous retinal detachment (SRD) in optic pits remains a mystery. Several hypotheses have been proposed that lead to different treatments based on the possible mechanisms which explain the occurrence of SRD. The literature data about fluorescein angiography mainly concern the angiographic aspects of the optic pit itself, and seldom the SRD. We have examined these fluorescein angiographic aspects of the SRD. Indocyanine cardiogreen video-angiography gives new information which question the last etiologic hypothesis., Methods: Nine patients underwent a fluorescein angiography when the SRD was discovered. Indocyanine cardiogreen was performed in four patients., Results: In 8 cases there was hyperfluorescence on the optic pit. In 7 cases in the peripapillar space of the SRD. In one of these cases, there was a leakage on the temporal margin of the optic nerve. In 8 cases in the SRD: we noticed a late minimal hyperfluorescence in the SRD but it already existed in the early angiogram. The SRD became hyperfluorescent in arterio-veinous retinal phase. In late phases we noticed a well-demarcated area of hyperfluorescence., Conclusion: These investigations have revealed a permeation problem on the blood-outer retinal barrier of the peripapillar space and above all from the edge of optic pit. This can have a prognosis value for SRD. The hyperfluorescence in SRD remains an enigma and does not allow, as we thought before, to confirm one of the etiopathogenic hypotheses. A better acknowledge of indocyane cardiogreen angiographic semiology will allow us to explain these aspects in the future.

Purpose: The pathogenesis of the sensory retinal detachment of the macula associated with congenital pit of the optic nerve remains controversal. Based on our cases and the cases reported in literature, we propose a management plan for macular retinal detachment associated with optic nerve pit., Methods: In this retrospective study ten eyes were treated for progressive visual loss. Treatment modalities were different depending on the time period: laser photocoagulation (to the juxtapapillary region) alone, laser combined with intraocular gas injection (C3 F8), laser combined with vitrectomy and intraocular gas tamponnade (S F6, C3 F8), laser combined with vitrectomy and temporary silicone oil tamponade., Results: The follow-up period ranged between one and five years (mean follow-up thirty three months). We had eight successes and two definitive failures (an old macular detachment treated only by one laser session, and a young girl who had not kept the prone position after gas injection). In the group of six eyes treated by laser alone, only two retinal treatments were directly successfully treated; in three other eyes, the detachment recurred and was treated with success in a second step by a gas injection; the sixth eye is the first definitive failure (old detachment). In the five eyes treated by laser combined gas injection with or without pars plana vitrectomy (including three failures of laser alone), the retina remained attached in four eyes during the follow-up period; the sixth eye was the second definitive failure (the young girl). In the both eyes treated by vitrectomy and silicon oil injection, the retina has flattened., Conclusion: The results suggest that laser photocoagulation alone is not so efficient and that vitrectomy is not necessary with gas injection. Complete resorption of subretinal fluid occurred in eight eyes: two with laser photocoagulation alone, and six with a long term tamponnade combined with a peripapillary laser photocoagulation. In first treatment, this technique (laser with tamponade) is a valuable approach to manage serous macular detachment associated with optic nerve pit.