Black flashes (dysphotopsia) as a symptom of vitreo-papillary traction in evolving posterior vitreous detachment - An optical coherence tomography case series.

PURPOSE

We present three cases of evolving posterior vitreous detachment (PVD) in which patients experienced black flashes, known as negative dysphotopsia (ND), and were found to have vitreo-papillary adhesion at the optic nerve head.

OBSERVATIONS

A 53-year-old female with a history of right rhegmatogenous retinal detachment (RRD) described initial symptoms of black flashes. Seven years later, she developed similar symptoms in the left eye and was diagnosed with PVD. OCT demonstrated vitreo-papillary adhesion.A 47-year-old male with a history of pseudophakic RRD in the left eye 5 years previously presented with black flashes in the right eye on eye movements. He was found to have PVD and RRD after 5 months of these symptoms. OCT revealed separation of the vitreous from the macula with attachment on the optic disc.A 51-year-old male developed ND which were replaced by white flashes after 3 weeks. A week later he was diagnosed with PVD and a retinal tear with OCT evidence of vitreo-papillary traction.

CONCLUSIONS AND IMPORTANCE

Evolving PVD may present with ND before classical symptoms such as positive dysphotopsia and floaters, particularly in cases with vitreo-papillary adhesion/traction.