Unilateral subclinical optic disc edema secondary to vitreopapillary traction syndrome

A 57-year old male patient reported a 15-min episode of transient amaurosis 2 years back, with persistent blurry vision in the right eye (OD), associated with sporadic headaches over the following 2 years. Visual acuity was 20/20 in both eyes. Fundoscopy of OD revealed mild optic disc edema (ODE) in the nasal sector and vascular changes in the optic disc compatible with venous shunting, corresponding to a prepapillary vascular loop. Fundoscopy of the left eye was normal. Imaging was performed to rule out intracranial hypertension and optic nerve meningioma. Optical coherence tomography revealed vitreopapillary traction syndrome (VTS) in OD, with preservation of the nerve fiber layer and ganglion cells. VTS is characterized by incomplete detachment of the posterior vitreous and adhesion of the vitreous to the optic disc, producing a persistent tractional pull. The main purpose of this report is to highlight the importance of including VTS in the differential diagnosis of patients with chronic ODE.