1. Vitrectomy and Release of Presumed Epipapillary Vitreous Traction for Treatment of Nonarteritic Anterior Ischemic Optic Neuropathy Associated with Partial Posterior Vitreous Detachment
- Author
-
Mehdi Modarres, Khalil Ghasemi Falavarjani, and Mostafa Soltan Sanjari
- Subjects
Adult ,Male ,Pars plana ,medicine.medical_specialty ,Visual acuity ,genetic structures ,medicine.medical_treatment ,Optic Disk ,Visual Acuity ,Optic disk ,Tissue Adhesions ,Vitrectomy ,Vitreous Detachment ,Posterior vitreous detachment ,Optic neuropathy ,Ophthalmology ,medicine ,Humans ,Optic Neuropathy, Ischemic ,Prospective Studies ,Aged ,Color Perception Tests ,business.industry ,Middle Aged ,medicine.disease ,eye diseases ,Surgery ,Vitreous Body ,medicine.anatomical_structure ,Anterior ischemic optic neuropathy ,Female ,sense organs ,Visual Fields ,medicine.symptom ,business ,Tomography, Optical Coherence - Abstract
Objective To study the results of vitrectomy and release of epipapillary vitreous adhesions for the treatment of nonarteritic anterior ischemic optic neuropathy (NAION) associated with partial posterior vitreous detachment (PVD). Design Prospective noncomparative interventional case series. Participants A series of 16 patients with clinical picture of NAION and small discs associated with partial PVD, diagnosed clinically and confirmed by optical coherence tomography and B-scan ultrasonography. Intervention All patients underwent standard pars plana vitrectomy with meticulous removal of epipapillary vitreous adhesions within 1 month from the onset of visual symptoms. Main Outcome Measures Best-corrected visual acuity (BCVA), mean deviation of visual fields, and color vision testing. Results In 15 patients BCVA improved (93.7%), mean preoperative BCVA was 6/38 (0.82±0.53 logarithm of the minimum angle of resolution [logMAR]), which improved to 6/18 (0.49±0.37 logMAR) postoperatively at 3 months. Nine eyes (56%) had ≥3 lines of visual improvement. Visual fields improved in 4 patients and color vision improved in 1 patient. Conclusion Vitreous traction from partial PVD may have a causative role in some cases of NAION associated with small discs. In these cases, vitrectomy and removal of epipapillary vitreous may result in improvement of visual acuity.
- Published
- 2007