Ultrastructural changes detected using swept-source optical coherence tomography in severe vitreopapillary traction: a case report

Arq Bras Oftalmol. 2019 Sep 30;82(6):517-521. doi: 10.5935/0004-2749.20190099. eCollection 2019.

Abstract

Vitreopapillary traction is an uncommon condition characterized by strong adhesion and the traction of the posterior hyaloid onto the optic disc and peripapillary retina, leading to optic disc elevation and visual loss. An 85-year-old man presented with a 6-month history of slow, progressive visual loss in the left eye along with optic disc edema. Swept-source optical coherence tomography B-scans revealed circumpapillary anterior-posterior persistent traction of dense vitreous strands onto the optic disc. Visual field examination demonstrated mild, generalized, diffuse sensitivity loss and blind-spot enlargement. A 25-gauge posterior vitrectomy was performed with posterior hyaloid separation from the optic disc, resulting in significant anatomical and visual improvement. In conclusion, swept-source optical coherence tomography aids in understanding the mechanism underlying visual loss in vitreopapillary traction. Moreover, posterior vitrectomy can effectively promote anatomical and visual improvements in these cases.

Publication types

  • Case Reports
  • Letter

MeSH terms

  • Aged, 80 and over
  • Blindness / etiology
  • Epiretinal Membrane / diagnostic imaging
  • Epiretinal Membrane / pathology
  • Humans
  • Male
  • Papilledema / diagnostic imaging*
  • Papilledema / pathology*
  • Papilledema / therapy
  • Severity of Illness Index
  • Tissue Adhesions
  • Tomography, Optical Coherence / methods*
  • Treatment Outcome
  • Visual Acuity
  • Vitreous Body / diagnostic imaging*
  • Vitreous Body / pathology*