The vitreopapillary interface in healthy and glaucoma – the VPI study

Abstract

PurposeDuring posterior vitreous detachment (PVD) the posterior hyaloid remains, for a certain period, attached to the posterior pole. At the macula, the vitreomacular interface and its associated disease has been studied extensively. The opposite is true for the vitreopapillary interface, especially in glaucoma patients. As glaucoma affects the shape and cupping of the optic nerve head, this study aims to investigate the possible influence of vitreous traction on the disc.MethodsThe VPI study (NCT02290795) is a cross‐sectional prospective study including healthy subjects and glaucoma patients. A subset of the glaucoma patients was followed‐up longitudinally to assess the impact of filtering surgery on the VPI. All glaucoma patients underwent a comprehensive ophthalmological investigation, automated visual field test, confocal scanner and OCT scan. Healthy subjects filled in a questionnaire on gender, age, medical history, medication use and had also had an OCT‐scan to determine PVD status.ResultsIn total, 258 healthy subjects and 349 glaucoma patients were included rendering data on 1214 eyes. Glaucoma patients were significantly older than their healthy counterparts (66.5 ± 12.8 vs. 60.1 ± 14.8, p < 0.001). Split up per PVD stage, the age did not differ in PVD stage 0, but for every following PVD stage, glaucoma patients were significantly older (54.2 ± 11.7 vs. 50.1 ± 14.4 (p = 0.071); 61.1 ± 10.4 vs. 54.7 ± 14.0 (p < 0.001); 72.5 ± 8.9 vs. 67.7 ± 5.9 (p < 0.001); 73.7 ± 9.9 vs. 71.4 ± 9.3 (p = 0.014) for PVD stage 0;1;3;4 respectively).ConclusionsThe process of PVD formation lasts significantly longer in glaucoma patients.