Role of the vitreous in the pathogenesis of diabetic vitreopapillary traction syndrome

The aim of this work was to study the role of the vitreous in the pathogenesis of diabetic vitreopapillary traction syndrome. Methods: We observed 70 diabetic patients with vitreopapillary tractional syndrome. The group included patients with its initial manifestations without fibrovascular membrans, as well as patients with the presence of a pronounced fibrovascular proliferation fixed to the optic nerve disk. All patients underwent standard ophthalmologic examinations and B-scan ultrasonography, OCT, perimetry, fluorescent angiography. All of them underwent vitreoretinal surgery, the purpose of which was to eliminate the traction component the vitreous.Results: Kinetic B-scan ultrasonography test unlike standard digital ultrasonography allowed to assess the mobility limitation of the vitreous and traction effect. OCT results demonstrate vitreopapillary fixation and parapapillary posterior vitreous detachment. Analysis of perimetry results showed that all patients had central and paracentral scotomas. Conclusions: The results of our own observations indicate that the biomechanical impact of vitreous on the optic nerve (an increase in traction) affects the progression of diabetic vitreopapillary traction syndrome and is one of the reasons for the deterioration of visual functions in this category of patients.