Does Vitreopapillary Traction Cause Nonarteritic Anterior Ischemic Optic Neuropathy?

Papillary vitreous detachment as a possible accomplice in non-arteritic anterior ischaemic optic neuropathy

“…7 Parsa suggested that this perception is open to scrutiny and encouraged researchers to use more imaging technologies to further clarify the role of vitreous separation in mechanical dynamic stretch injury to the optic disc in patients with NAION. 6 Our study provides reliable evidence of papillary vitreous detachment-related traction in NAION development using…”

“…Therefore, the inclusion criteria for normal individuals were (1) age, sex, hypertension and diabetes matched with NAION patients; (2) incomplete or complete papillary vitreous detachment; (3) best-corrected visual acuity (BCVA) ≥0.8; (4) intraocular pressure (IOP) ≤21 mm Hg with no history of elevated IOP; (5) no history of optic neuropathy, optic pathway or central nervous system disorders; (6) no obvious turbidity of the refractive medium and no history of ocular trauma. The exclusion criteria were (1) axial length ≥25.5 mm (2) absence of papillary vitreous detachment.…”

“…26 Parsa suggested that vitreopapillary traction should not be confused with dynamic papillary vitreous detachment. 6 First, once the vitreous body begins to undergo liquefaction and papillary vitreous detachment, it is kinetic in the eye and has traction related to the body position or the rapid eye movement sleep process. 29 Second, the traction generated from the separation of the optic disc and vitreous body is not necessarily persistent or 'V-shaped' on OCT scan, it may be intermittent.…”

“…29 Second, the traction generated from the separation of the optic disc and vitreous body is not necessarily persistent or 'V-shaped' on OCT scan, it may be intermittent. 6 These instantaneous and intermittent forces produced in papillary vitreous detachment are difficult to capture using OCT. This differs from the static or V-shaped vitreous traction mentioned previously.…”

“…Vitreous separation alone is insufficient for producing NAION, as vitreous separation speed at the papilla level and age-related axonal fragility are two other main factors. 6 When such papillary vitreous detachment is accompanied by vision loss and visual field defects, occasionally rapid vitreous traction on the papilla caused by a rotational body or eye movement may trigger further axonal rupture and progressive vision loss frequently referred to as 'progressive' or 'recurrent' NAION. 6 At the 2-month follow-up, case 2 had a worsened visual field defect.…”