Vitreopapillary Traction in Nanarteritic Anterior Ischemic Optic Neuropathy

To describe the association between vitreous traction on the optic disc and nonarteritic anterior ischemic optic neuropathy (NAION). Eighty three eyes of 83 patients with NAION were evaluated by optical coherence tomography (OCT) for detecting vitreous adhesion to the optic nerve head with separation from the adjacent retina (partial posterior vitreous detachment). Eyes which were negative for such adhesion underwent ultrasonography to detect complete posterior vitreous detachment (PVD). Fifty male and 33 female subjects with mean age of 51.9±10 years were studied. Partial PVD with optic nerve head adhesion was found in 54 patients (65.1%) using OCT. Ultrasonography detected complete PVD in all other eyes with optically empty spaces on OCT. Vitreous traction on the optic nerve head from partial PVD may play a causative role in some cases of NAION. This traction may impair vascular supply and/or axoplasmic flow leading to signs and symptoms of NAION.