Three-dimensional depiction of the vitreous pocket using triamcinolone acetonide.

Purpose: To clarify the three-dimensional morphology of the vitreous pocket by direct injection of triamcinolone acetonide (TA) into the vitreous pocket.

Methods: Ten eyes of 10 subjects with incomplete posterior vitreous detachment (PVD) were studied. During vitreous surgery, TA was directly injected into the vitreous pocket. A 25-G cutter was then inserted into the vitreous pocket and TA was removed by aspiration. The anterior surface of the vitreous pocket was removed with the 25-G cutter, and the posterior side of the vitreous pocket was observed.

Results: Injecting TA allowed visualization of the circular vitreous pocket located anterior to the optic disk and macular area in all 10 eyes. The surface of the anterior border had a bright appearance. In 2 eyes without PVD, the posterior side of the vitreous pocket was depicted as a flat plate-like structure encompassing the macular region and the optic disc. In 8 eyes with partial PVD around the optic disc, a larger flat plate with the macula as the center and a smaller plate with the optic disc as the center were observed.

Conclusions: The vitreous pocket is a disc-shaped liquefied lacuna spreading anterior to the optic disc and macular region, which is surrounded by a dense network of fibrils. In patients with partial PVD around the optic disc, the posterior wall was visualized as being composed of two plate-like structures with the macula and the optic disc at their centers.