Are you surprised there might be a connection?...
There appears to be an interplay between Posterior Vitreous Detachment (PVD) and Ischemic Optic Neuropathy (ION), particularly non-arteritic anterior ischemic optic neuropathy (NAION). This altered physical relationship between the vitreous and optic nerve with underlying ischemic pathophysiology is important for us to understand and consider.
Potential tractional forces may create and/or exacerbate optic nerve ischemic conditions. Current thinking involves a theory which optic disc edema associated with ischemic optic neuropathy may induce PVD by disrupting the vitreopapillary interface, or vica-versa, whereby the mechanics of developing PVD my induce an ischemic environment at the level of the optic nerve head. It is this potential back and forth self-perpetuating cycle for us to remember - especially with higher risk individuals.
We know the risk and incidence of both NAION and PVD significantly increases with age. An age-related correlation matters for our older patients who come to see us with visual disturbances. By recognizing and understanding this potential anatomic biomechanical interplay, we can more likely provide timely diagnosis and management.
- JRM
Go to the article in BMC Ophthalmology HERE.
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