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Shimon Rumelt, MD; Muge Karatas, MD; Joseph Pikkel, MD; Michael Majlin, MD; Avinoam Ophir, MD

Arch Ophthalmol. 2003;121:1093-1097.

Objective  To describe the association between ischemic central retinal vein occlusion (CRVO) and the development of optic disc (vitreopapillary) traction, as verified by optical coherence tomography (OCT).

Methods  In a prospective, noncomparative, observational patient series, 3 women aged 51 to 64 years developed an ischemic type of CRVO. One patient underwent cannulation of the central retinal vein with injection of a tissue plasminogen activator. In each eye, the contour of the optic nerve head could not be accurately detected because of overlying fibrous tissue. Each patient underwent OCT examination 6 to 10 months (average, 8.3 months) after the occlusive event.

Results  Optic disc traction was found by OCT in the 3 patients. In each, the disc was elevated, associated with either incomplete posterior vitreous detachment (2 eyes) or vitreopapillary fibrous membrane (1 eye). Secondary peripapillary retinal traction and macular or retinal detachment developed ("optic disc traction syndrome"). These findings were less marked, or not evident, on both clinical examination and ocular ultrasonography.

Conclusions  Optic disc traction and secondary localized retinal detachment can develop after ischemic CRVO and may contribute to the poor visual acuity. This syndrome should merit special attention before surgery for CRVO is planned. The use of OCT was helpful to diagnose this syndrome.

From the Department of Ophthalmology, Western Galilee, Nahariya Medical Center, Nahariya, Israel (Dr Rumelt); Department of Ophthalmology, Hillel-Yaffe Medical Center, Hadera, Israel (Drs Karatas, Pikkel, and Ophir); Medical Eye Institute, Haifa, Israel (Dr Majlin); and Bruce Rappaport Faculty of Medicine, The Technion, Haifa (Dr Ophir). The authors have no relevant financial interest in this article.

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