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To the Editor.
—The unusual and well-documented report of a case in the Archives by Norman E. Byer, MD (90:133-135,1973), is an important contribution and interesting for several reasons. First, the tear of the nasal parapapillary retina is a rare lesion that I feel certain was caused by posterior vitreous detachment (PVD) combined with an epipapillary membrane (EPM). Such tears were portended by de Vries (Ophthalmologica 122:245, 1951) and documented in two cases by Favre (Ophthalmologica 127:351, 1954).In a recent report, the fundamental nature of vitreopapillary attachments and the common complications resulting from PVD were detailed (Foos RY, Roth AM: Am J Ophthalmol 76:662, 1973). The study showed that vitreous adherence to EPM (through incarceration of vitreous filaments between glial cells) is usually stronger than EPM adherence to optic disc and adjacent nasal retina (through interconnecting glial cell processes). Posterior vitreous detachment, under these common circumstances, usually leads to
Foos RY. Retinal Tears. Arch Ophthalmol. 1974;91(6):519-520. doi:10.1001/archopht.1974.03900060533024