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J. Sherman, S. Nath, A. A. Sadun, V. Wong, A. Delgado, J. Boneta, W. He; Spectral OCT Reveals Bergmeister's Papillae in the Majority of Normal, Young Patients. Invest. Ophthalmol. Vis. Sci. 2008;49(13):929.
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© ARVO (1962-2015); The Authors (2016-present)
To determine the prevalence of Bergmeister’s Papillae in young, healthy adults.
One-hundred eyes of fifty consecutive young adults (age range 20-30) were examined clinically and with Topcon 3D OCT 1000, a spectral or Fourier domain OCT. None of the patients had any syndromes associated with persistent fetal vasculature such as Knobloch Syndrome. The clinical exam included best corrected VA, refractive error, slit lamp, and ophthalmoscopy of the posterior pole with emphasis on disc assessment. A spectral OCT of 6 x 6 mm was centered on the optic nerve head that resulted in 128 horizontal cross sections. Sections through the optic disc were scrutinized separately by 2 observers who assigned each disc to one of three categories: 1) No evidence of tissue arising from the disc and extending into the vitreous, 2) Evidence of disc tissue extending into the vitreous at least 150 u in length that was similar in appearance to reference histopathological images of Bergmeister’s papillae from standard texts (Barber, A.N. Embryology of the Human Eye,1955; Smelser, G.K. The Structure of the Eye, 1961), 3) Evidence of disc tissue less than 150 u in length that did or did not bear resemblance to the reference images above. Epipapillary membranes were included in this category.
Examiner #1 detected Bergmeister’s papillae in 72% of the eyes as defined in category 2 above. Fourteen percent of eyes were classified into category 1, and 14% were classified into category 3 above. Examiner #2 differed by at most 2 eyes in each category from examiner #1. Bergmeister’s papillae were not detected clinically in any of these eyes. The OCT detected that Bergmeister’s papillae arose from the inferior disc vessels in virtually every case, as predicted from known embryology (Wolff’s Anatomy of the Eye & Orbit, 7th Ed., 1976).
Ophthalmoscopically visible Bergmeister’s papillae do not appear to be common, but spectral domain OCT documented Bergmeister’s papillae in the majority of young, normal eyes. Resolution of spectral OCT may reveal findings invisible to standard ophthalmoscopy. Knowledge of what is "normal" with spectral OCT may prevent such normal findings from being misclassified as abnormal resulting in unwarranted intervention.
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