Changes in the vitreomacular interface in patients with diabetic vitreopapillary traction syndrome using optical coherence tomography

Relevance Diabetic retinopathy (DR) is the leading cause of blindness among the working-age population [1]. One of the most common manifestations of proliferative DR is vitreopapillary traction syndrome (VPTS) [2]. Given the long-term latent course, great importance in the formation of clinical manifestations of diabetic VPTS is emphasized on the development of partial optic nerve atrophy [3]. Along with this, less attention is paid to the effect of VPTS on the macular zone, which may be a key reason for the unfavorable prognosis of treatment [4]. Objective To evaluate changes in the vitreomacular interface in patients with diabetic VPTS using optical coherence tomography (OCT). Material and methods The study included 66 patients with diabetic VPTS. They were divided into 2 groups: Group 1 - 42 eyes with pronounced FVS originating from the optic disc; Group 2 – 24 eyes with initial manifestations of VPTS. The patients underwent OCT in the “cross line” mode. Results According to OCT data, half of the patients in Group 1 had a macular shift towards the optic disc. OCT in patients of Group 1 in dynamics shows that proliferations were first fixed at the base of the optic lenticular canal, and then moved through the connecting canal to the macular zone. Tractional displacement of the macula occurred with varying severity of FVS, which is associated with different heights of the junction of the peripapillary lacuna and premacular bursa with the canal in relation to the optic disc. Conclusion OCT allows us to take a new look at the pathophysiology of changes in the vitreomacular interface in patients with diabetic VPTS. One of the key factors influencing the formation of low vision in patients with diabetic VPTS is changes in the vitreomacular interface, which requires timely treatment. Key words: vitreopapillary traction syndrome; diabetic retinopathy; optical coherence tomography