Vitreopapillary Tractions

Vitreo-papillary tractions develop in the posterior vitreous detachment (PVD) development process that vitreous cannot pass the separation process from papilla. Distortion of the nerve fiber layer and microvascular structures in the papillae by the posterior hyaloid traction causes deterioration of visual functions. Conditions causing local ocular anatomic variations, such as small crowded papillae, previous trauma, intraocular surgery, intraocular inflammations, intraocular vascular problems may be predisposing for abnormal PVD. Vitreopapillary tractions (VPT) can be classified as primary if there is no other ocular pathology that can lead to anormal PVD, and secondary, if there is a concurrent pathology that can lead to anormal PVD. Three types of VPT’s are defined according to the Optical coherence tomography (OCT) based classification. Type 1: vitreous band traction on the optic disc Type 2: prominent vitreous condensation at the optic disc surface and cup, Type 3: elevation of the anterior optic disc cup border above the level of the retina pigment epithelium/Bruch’s membrane. Diagnosis is made by clinical examination ultrasonography and OCT findings. Vitrectomy is performed in situations that threaten visual functions in the treatment.