Three-dimensional depiction of the vitreous pocket using triamcinolone acetonide

Abstract

Purpose

To clarify the three-dimensional morphology of the vitreous pocket by direct injection of triamcinolone acetonide (TA) into the vitreous pocket.

Methods

Ten eyes of 10 subjects with incomplete posterior vitreous detachment (PVD) were studied. During vitreous surgery, TA was directly injected into the vitreous pocket. A 25-G cutter was then inserted into the vitreous pocket and TA was removed by aspiration. The anterior surface of the vitreous pocket was removed with the 25-G cutter, and the posterior side of the vitreous pocket was observed.

Results

Injecting TA allowed visualization of the circular vitreous pocket located anterior to the optic disk and macular area in all 10 eyes. The surface of the anterior border had a bright appearance. In 2 eyes without PVD, the posterior side of the vitreous pocket was depicted as a flat plate-like structure encompassing the macular region and the optic disc. In 8 eyes with partial PVD around the optic disc, a larger flat plate with the macula as the center and a smaller plate with the optic disc as the center were observed.

Conclusions

The vitreous pocket is a disc-shaped liquefied lacuna spreading anterior to the optic disc and macular region, which is surrounded by a dense network of fibrils. In patients with partial PVD around the optic disc, the posterior wall was visualized as being composed of two plate-like structures with the macula and the optic disc at their centers.