Vitreopapillary Traction

Vitreopapillary traction. Note the mild peripheral obscuration of retinal vessels in both eyes with relative preservation of the optic disc margins.

Optical coherence tomography of vitreopapillary traction (same patient). Bilateral vitreopapillary traction noted.

Fluorescein angiography of vitreopapillary traction (same patient). Note the mild focal leakage seen in both eyes (perhaps slightly more prominent in the left eye).

Image credit: Houle E, Miller NR. Bilateral vitreopapillary traction demonstrated by optical coherence tomography mistaken for papilledema. Case Rep Ophthalmol Med 2012;2012:682659. doi: 10.1155/2012/682659. Available online. Used for educational purposes.

Vitreopapillary Traction

Vitreopapillary traction. A, Photograph of the right optic nerve shows disc elevation, blurred margins, and obscuration of nasal vessels. B, Transverse optical coherence tomography reveals peripapillary vitreous adhesion and traction, resulting in elevation of the optic disc and peripapillary retina.

Image credit: Simonett JM, Winges KM. Vitreopapillary traction detected by optical coherence tomography. JAMA Ophthalmol 2018;136(5):e180727. doi: 10.1001/jamaophthalmol.2018.0727. Available online. Used for educational purposes.

Vitreopapillary Traction

Vitreopapillary traction. The condensation of vitreous over the optic nerve can cause the optic nerve to look blurred, and the traction itself can result in elevation of the optic nerve and blur the edges of the optic nerve.

Image credit: Courtesy of Alex P. Hunyor, M.D. Retina Image Bank. American Society of Retina Specialists. Available online. Used for educational purposes.

Prepapillary Hemorrhage

Prepapillary hemorrhage. Partial posterior vitreous detachment in a myopic Asian patient.

Image credit: Katz B, Hoyt WF. Intrapapillary and peripapillary hemorrhage in young patients with incomplete posterior vitreous detachment. Signs of vitreopapillary traction. Ophthalmology 1995;102(2):349-54. Spencer S. Eccles Health Sciences Library, University of Utah, 2002. Neuro-ophthalmology Virtual Education Library. Available online. Used for educational purposes.

Glial Veil

Glial veil.

Image credit: American Academy of Ophthalmology. Used with permission for educational use.

Glial Tuft

Glial tuft.

Image credit: American Academy of Ophthalmology. Used with permission for educational purposes.

Bergmeister Papilla

Bergmeister papilla (histopathology). A, Gross photograph of infant eye showing fingerlike projection of whitish tissue (arrow) from the surface of the optic nerve head. B, Low-magnification photomicrograph of part A showing fibroglial tissue (arrow) projecting into the vitreous cavity from the optic nerve head. C, High-magnification photomicrograph of Bergmeister papilla demonstrating loose fibrous connective tissue with small capillary (arrow), surrounded by a thin layer of fibrous astrocyte-like cells (arrowhead).

Image credit: Courtesy of Robert H. Rosa, Jr., M.D. American Academy of Ophthalmology. Used with permission for educational purposes.

Bergmeister Papilla

Bergmeister papilla.

Image credit: Courtesy of Kathleen Digre, M.D. Spencer S. Eccles Health Sciences Library, University of Utah, 2012. Neuro-ophthalmology Virtual Education Library. Available online. Used for educational purposes.

Crowded Optic Nerve

Crowded optic nerves. Note the anomalous vasculature and scalloped edges of the optic disc.

Image credit: Courtesy of William F. Hoyt, M.D. Spencer S. Eccles Health Sciences Library, University of Utah, 2002. Neuro-ophthalmology Virtual Education Library. Available online. Used for educational purposes.

Crowded Optic Nerve

Crowded optic nerve with glial remnant. Note the glial remnant in the right eye.

Image credit: Courtesy of William F. Hoyt, M.D. Spencer S. Eccles Health Sciences Library, University of Utah, 2002. Neuro-ophthalmology Virtual Education Library. Available online. Used for educational purposes.

Crowded Optic Nerve

Crowded congenital blurred disc. Note the anomalous vascular pattern and glial tissue on the disc in the right eye.

Image credit: Courtesy of William F. Hoyt, M.D. Spencer S. Eccles Health Sciences Library, University of Utah, 2002. Neuro-ophthalmology Virtual Education Library. Available online. Used for educational purposes.

Hyperopic Optic Nerve

Hyperopic optic nerve. Note the crowded appearance of the optic nerve with nasal elevation. There is mild venous tortuosity, which can suggest venous outflow congestion and obscure the diagnosis. There is some anomalous branching of the retinal vessels, suggestive of pseudopapilledema. Despite the elevation and crowding of the optic disc, there is no whitening of the peripapillary retinal nerve fiber, no obscuration of the retinal vessels, no retinal or choroidal folds, and no nerve fiber layer hemorrhages.

Image credit: Karl Golnik, M.D. on UpToDate. Available online. Used for educational purposes.

Hyperopic Optic Nerve

Hyperopic optic nerve. Note the generally ill-defined appearance to the optic nerve, with obscuration of the nasal contour. There is a small cup, and there may be a very slight elevation to the superior edge of the optic nerve. However, there is no whitening of the peripapillary nerve fiber layer, no obscuration of the retinal vessels, no venous engorgement or tortuosity, no true blurring of the nerve margins, no hemorrhages, and no retinal or choroidal folds.

Image credit: Appearance of optic nerve disorders. Entokey. Available online. Used for educational purposes.

Myelinated Nerve Fibers

Myelinated nerve fibers.

Image credit: Courtesy of Anthony C. Arnold, M.D. American Academy of Ophthalmology. Used with permission for educational purposes.

Myelinated Nerve Fibers

Myelinated nerve fibers.

Image credit: American Academy of Ophthalmology. Used with permission for educational purposes.

Myelinated Nerve Fibers

Myelinated nerve fibers

Image credit: American Academy of Ophthalmology. Used with permission for educational purposes.

Myelinated Nerve Fibers

Myelinated nerve fibers.

Image credit: Courtesy of Rod Foroozan, M.D. American Academy of Ophthalmology. Used with permission for educational purposes.

Myelinated Nerve Fibers

Myelinated nerve fibers.

Image credit: American Academy of Ophthalmology. Used with permission for educational purposes.

Myelinated Nerve Fibers

Myelinated nerve fibers.

Image credit: American Academy of Ophthalmology. Used with permission for educational purposes.

Myelinated Nerve Fibers

Myelinated nerve fibers.

Image credit: Courtesy of Andre Marques, M.D. American Academy of Ophthalmology. Used with permission for educational purposes.