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Tadashi Yokoi, Noriyuki Azuma; Development of a Premacular Vitreous Pocket. Invest. Ophthalmol. Vis. Sci. 2013;54(15):5854.
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© ARVO (1962-2015); The Authors (2016-present)
The premacular vitreous pocket (PVP) is important structure that is related to various macular diseases, including macular holes and diabetic maculopathy. However, it has been unknown how the pocket develops.
We analyzed the posterior vitreous, retinas, and optic discs of 56 healthy eyes (39 patients; age range, 1-54 years) using swept-source OCT (Topcon, Tokyo, Japan), which provides the detailed images of the fine structures. Eyes that appeared healthy were excluded if the patient had a family history of a hereditary vitreoretinal disease.
A PVP was detected in all eyes of patients older than 10 years and in no eyes of patients younger than 2 years. A vitreous laceration, considered to be a primitive structure of the premacular vitreous pocket, develops first in eyes around 2 years of age. Between 3 and 9 years, a PVP was present in 49% of eyes and a vitreous laceration in 61%. Fifty-five percent of eyes with a PVP also had a vitreous laceration, and 80% had a liquefied cavity connected to the PVP and Cloquet’s cana. The connection to Cloquet’s canal was identified in the PVP and the vitreous laceration. In younger eyes, the PVP was wider horizontally than vertically, and all detectable vitreous lacerations were longer horizontally than vertically. During the early phase of PVP development, several eyes had multifocal PVPs and vitreous lacerations in the premacular vitreous. A high-density structure, which appeared to be a remnant of regressed hyaloid vessels, connected to Bergmeister’s papilla, was present temporally along the laceration and wall of the PVP.
Formation of PVPs begins with a vitreous laceration, focally or multifocally, and Cloquet’s canal, a remnant of regressed hyaloid vessels and eye movement may play important role in its development.
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