Vitreous anatomy and the vitreomacular correlation

Area of Science:

• Ophthalmology
• Vitreoretinal interface diseases
• Anatomy and physiology of the eye

Background:

• The posterior precortical vitreous pocket is a collagen sheet separated from the vitreous gel in the macula.
• This pocket, with strong vitreoretinal attachment at the fovea, is implicated in perifoveal posterior vitreous detachments.
• These detachments can lead to serious conditions like macular holes, premacular membranes, and diabetic retinopathy complications.

Purpose of the Study:

• To discuss the role of the precortical pocket in various vitreoretinal interface diseases.
• To explore the developmental aspects of the precortical pocket and associated structures.
• To investigate the potential physiological role of the precortical pocket as an aqueous humor drainage route.

Main Methods:

• Review of pioneer studies on the vitreous in postmortem eyes.
• Analysis of swept-source optical coherence tomography (SS-OCT) imaging.
• Discussion of anatomical and physiological implications.

Main Results:

• SS-OCT imaging revealed the development of the precortical pocket, connecting channel, and Cloquet's canal during early childhood.
• The findings suggest a potential pathway for aqueous humor drainage into the precortical pocket.
• The study highlights the significance of the precortical pocket in the context of vitreoretinal interface diseases.

Conclusions:

• The precortical pocket plays a crucial role in the pathogenesis of several vitreoretinal diseases.
• Early childhood development of the precortical pocket indicates a potential physiological drainage function.
• Further research is needed to elucidate the hypothesis of anterior chamber-macula crosstalk via this route.