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Optic disc anatomy

I'm considering laser vitreolysis to remove a Weiss ring floater. One doctor told me that there is a risk that the floater could break free during treatment and then float posteriorly toward the retina and be more noticeable. Another told me that if it broke free it would likely move anteriorly and be less noticeable. My question involves the anatomy of the tissue surrounding the optic disc where this tissue originates. Is this tissue attached to the inside of the vitreous sac surrounding the optic disc or the outside? And what happens in a PVD at this spot? Does the vitreous sac detach as a whole in which case the Weiss ring will be on the inside or outside depending on the anatomy...or, can the vitreous sac come apart at that point such that the Weiss ring can end up on either side? The answer may determine whether or not I take the risk to have the floater treated.
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Avatar universal
I know you had a couple of the same procedures I have had done, Crystalens and Yag laser. I had both of these as well as LASIK enhancement and steroid injection for macular edema. Anyway, in the months or years following, I experienced a posterior vitreous detachment in each eye and immediately thereafter had the Weiss ring appear. The PVD experience was a period of weeks during which I saw flashes of light when my eyes darted back an forth, especially in a darkened room. It was during this time the Weiss ring appeared as a dark shadowy spot that darts around continually. It is a piece of the membrane that pulled away from the retina during my vitreous detachment.
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Avatar universal
Hi, I wonder if I also have a Weiss ring floater.  Do you know when you noticed it or how you got it?
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Avatar universal
Dr. Kutryb,
I have had more than one retina specialist evaluate the floater and I know the location of it in relationship to the retina. It is centered in the vitreous and is in a good location for the laser to safely reach it. My well-respected retina doctor at the UAB Callahan Eye Foundation supports having it treated and see minimal risk. It is covered by my Blue Cross. (Yes, they recognize it, have codes for it and pay for it with only the office procedure co-pay for my part.)
My question was NOT regarding the location of the floater in an anterior/posterior direction. My question was regarding the location of the floater in relationship to the the vitreous face. Does the optic nerve head connective tissue that becomes a Weiss ring end up attached to the hyaloid membrane on the INSIDE or OUTSIDE? This would determine if the floater would float posteriorly or anteriorly if the laser caused it to become untethered at some point during treatment.
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284078 tn?1282616698
MEDICAL PROFESSIONAL
If you have a posterior vitreous detachement usually the remaining vitreous is pretty far away from the optic nerve and the retina. If any doubt a retinal specialist can easily show you the location of the floaters and sometimes a B-scan can actually show you the remaining vitreous face and its location in relation to the retina.  You don't want to have any laser vitreolysis to any floaters unless they are a good distance from the optic nerve and retina.  Even then, there is not a lot of peer reviewed literature to confidently support the treatment.  It's would be just hoping it would work on your part and certainly would not be insurance covered.  Maybe you should get an opinion with another retinal specialist before proceeding since you have doubts which are quite legitimate.  This is not mainstream treatment but could possibly be of benefit in just the right cases.  I'm definitely not sure if you are a good candidate at all.

MJK MD
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