Vitreous anatomy and the vitreomacular correlation

The presence of a posterior precortical vitreous pocket, referred to as a precortical pocket, implies that the vitreous cortex is formed into a collagen sheet separated from the gel in the macula. Along with strong vitreoretinal attachment at the fovea, the precortical pocket plays a role in perifoveal posterior vitreous detachments, which may lead to macular holes, premacular membranes, and ring-shaped proliferation in diabetic retinopathy. I and my colleagues published pioneer studies of the vitreous in postmortem eyes. Here, the role of the precortical pocket in various vitreoretinal interface diseases is discussed. Swept-source optical coherence tomography showed development of the precortical pocket, the connecting channel, and Cloquet's canal during early childhood. These findings raised the possibility that aqueous humor may drain into the precortical pocket. The physiologic role of the drainage route is also discussed. Crosstalk between the anterior chamber and macula is an attractive hypothesis and remains to be elucidated.