Kroll P, Wiegand W, Schmidt J
Medizinisches Zentrum für Augenheilkunde, Philipps-Universität Marburg.
Ophthalmologe. 1995 Oct;92(5):687-91.
In patients with proliferative diabetic vitreoretinopathy the authors noticed tractive vitreoretinal distortion of the optic disk to the nasal side. As a result of this distortion a reduction in visual acuity, pallor of the optic disk, and changes in the visual evoked potentials were registered. The disease in called "tractive vitreoretinal opticopathy."
We examined 15 diabetics with vitreoretinal traction and temporal pallor of the optic disk, as well as a reduction in visual acuity. Six patients were observed retrospectively and 9 patients prospectively before and after vitrectomy. Pre- and postoperative examinations included visual acuity, visual field, fluorescence angiography, and the conduction of visual evoked potentials (VEP).
Within a postoperative follow-up of 2-8 months (mean 6.5 months) a return of optical vitality combined with an increase in visual acuity could be seen in 14 of 15 patients. In addition, some of the patients showed an improvement in the amplitudes and a reduction in the latency of the VEP.
The authors assume that the axoplasmatic flow in the optic nerve fibers is reduced according to vitreoretinal traction. Furthermore, the traction may cause elongation of the capillaries, resulting in reduced perfusion of the optic disk. For these reasons early vitrectomy in patients with tractive vitreoretinal opticopathy is recommended.
