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BOOK TITLE: Retina: Medical and Surgical Management
This chapter basically talks about the vitreomacular interface and anomalous posterior vitreous detachment. Attachment of vitreous body with the inner retina is referred to as vitreoretinal interface which is composed of vitreous cortex, internal limiting membrane (ILM) and Muller cell foot plates. It is a complex structure leading to an array of disorders when it deviates from its normal anatomy. Phenomenon of separation of vitreous from the retina and the optic disc is known as posterior vitreous detachment (PVD). Occurrence of liquefaction more than the vitreoretinal separation leads to anomalous PVD. If the peripheral adhesions are stronger, APVD leads to retinal tears while if the attachment is stronger at the macula, APVD causes vitreomacular traction syndrome, vitreoschisis, macular holes, epiretinal membrane, diabetic macular edema and new evidence suggests that even age-related macular degeneration is associated. Ocriplasmin is a truncated form of human plasmin with a molecular weight of 27 KDa which helps in dissolution of laminin and fibronectin which are abundant at the vitreoretinal interface.
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