Review of Vitreopapillary Traction Syndrome

Abstract

Vitreopapillary traction (VPT) syndrome is a potentially visually significant disorder of the vitreopapillary interface characterised by an incomplete posterior vitreous detachment with the persistently adherent vitreous exerting tractional pull on the optic disc and resulting in morphologic alterations and a consequent decline of visual function. It is most commonly unilateral but bilateral reports have also been described. The cause of the condition may be unknown or idiopathic, although the histology of traction shows proliferation of fibrous astrocytes, myofibroblasts, fibrocytes, and retinal pigment epithelial cells. It is theorised that VPT may induce a congested optic disc with neuronal dysfunction as well as decreased prelaminar flow. The present study reviews and summarises the features, diagnosis, and management of VPT.

Keywords: Vitreopapillary traction; optic disc; optic neuropathy; posterior vitreous detachment; visual field loss.

Figure 1.

Fundus photographs demonstrating vitreopapillary traction. (a) Photographs of the left eye showing adhesions extending beyond the disc. (b) Postoperative photo showing improvement in retinal vasculature and disc margins.

Figure 2.

A 24–2 visual field of a patient who presented with the complaint of a “black kidney bean smudge” in her vision. The patient was found to have a VPT.

Figure 3.

Optical coherence tomography showing various horizontal slices of the vitreopapillary traction centred on the optic nerve.