Vitrectomy and release of presumed epipapillary vitreous traction for treatment of nonarteritic anterior ischemic optic neuropathy associated with partial posterior vitreous detachment.
OBJECTIVE
To study the results of vitrectomy and release of epipapillary vitreous adhesions for the treatment of nonarteritic anterior ischemic optic neuropathy (NAION) associated with partial posterior vitreous detachment (PVD).


METHODS
Prospective noncomparative interventional case series.


METHODS
A series of 16 patients with clinical picture of NAION and small discs associated with partial PVD, diagnosed clinically and confirmed by optical coherence tomography and B-scan ultrasonography.


METHODS
All patients underwent standard pars plana vitrectomy with meticulous removal of epipapillary vitreous adhesions within 1 month from the onset of visual symptoms.


METHODS
Best-corrected visual acuity (BCVA), mean deviation of visual fields, and color vision testing.


RESULTS
In 15 patients BCVA improved (93.7%), mean preoperative BCVA was 6/38 (0.82+/-0.53 logarithm of the minimum angle of resolution [logMAR]), which improved to 6/18 (0.49+/-0.37 logMAR) postoperatively at 3 months. Nine eyes (56%) had > or =3 lines of visual improvement. Visual fields improved in 4 patients and color vision improved in 1 patient.


CONCLUSIONS
Vitreous traction from partial PVD may have a causative role in some cases of NAION associated with small discs. In these cases, vitrectomy and removal of epipapillary vitreous may result in improvement of visual acuity.
Modarres
Mehdi
M
Department of Ophthalmology, Rasool Akram Medical Center, Tehran, Iran. modarreszif@yahoo.com
Sanjari
Mostafa Soltan
MS
Falavarjani
Khalil Ghasemi
KG
D000328:Adult; D000368:Aged; D003119:Color Perception Tests; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009898:Optic Disk / Q000473:pathology*; D018917:Optic Neuropathy, Ischemic / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D011446:Prospective Studies; D000267:Tissue Adhesions / Q000473:pathology*; D041623:Tomography, Optical Coherence; D014792:Visual Acuity; D014794:Visual Fields; D014821:Vitrectomy / Q000379:methods*; D014822:Vitreous Body / Q000473:pathology*; D020255:Vitreous Detachment / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*