Ophthalmologe. 2004 Feb;101(2):153-7
Hochwarter A, Prainer C, Binder S, Stolba U.
Augenabteilung, Krankenanstalt Rudolfstiftung und Ludwig-Boltzman-Institut fur Retinologie und biomikroskopische Laserchirurgie, Wien.
From January to December 2001, 89 patients with multiple sclerosis (MS) were treated in our hospital; 24 of them were diagnosed for the first time.
All patients underwent a complete ophthalmologic examination including a three-mirror contact lens examination when photopsias were found or the disease was diagnosed primarily.
Two patients showed vitreoretinal tractions with signs of periphlebitis before clinical-neurological manifestation of multiple sclerosis.
The third patient, in whom the disease had been known for years, showed distinct neovascularizations, vasculitis, and recurrent vitreous hemorrhages.
High-dose steroid therapy resulted in stabilization of the retinal situation in one patient, but the tractions remained unchanged.
Additional laser coagulation in the second patient achieved stabilization and reduction of the tractions.
A pars plana vitrectomy led to stabilization of the retinal proliferation in the third patient.
The vitreoretinal traction syndrome is associated with MS and can precede its clinical-neurological manifestation.
The good results after argon laser coagulation and vitreoretinal surgery suggest a vascular pathogenesis of these tractions.