He explains that PVD typically begins at the perifoveal macula, progresses to the peripheral retina and the optic disc is usually the final point of attachment.
Evolution of PVD has been described by an optical coherence tomography (OCT) study by Johnson in 2010. Posterior vitreous detachment (PVD) is defined as a separation between the posterior vitreous cortex and the inner limiting membrane of the retina and is typically innocuous. With aging of the vitreous, there is breakdown of collagen fibrils and loss of proteoglycans, resulting in liquefaction of the gel structure and the development of fluid-filled pockets, typically beginning in the front of the macula and in the central vitreous cavity. The vitreous humor is comprised of a meshwork of collagen fibrils with hyaluronic acid, forming a gel structure to fill the center of the eye. The tractional forces from the vitreous cortex may lead to morphologic disturbance of the attached structures, resulting in visual disturbances.
Vitreopapillary traction (VPT) syndrome is characterized by incomplete vitreous separation with persistent vitreous attachment to the peripapillary region.
