|Year : 2022 | Volume
| Issue : 1 | Page : 277-278
An insight on Bergmeister's Papillae
Prateek Jain, Anshuman Pattnaik, Pooja Shinde
Department of Community Ophthalmology, Global Hospital Institute of Ophthalmology, Abu Road, Sirohi, Rajasthan, India
|Date of Submission||13-Apr-2021|
|Date of Acceptance||07-Jul-2021|
|Date of Web Publication||07-Jan-2022|
Dr. Prateek Jain
Consultant, Department of Community Ophthalmology, Abu Road, Sirohi - 307 510, Rajasthan
Source of Support: None, Conflict of Interest: None
Keywords: Bergmeister's papilla, hyaloid artery, OCT
|How to cite this article:|
Jain P, Pattnaik A, Shinde P. An insight on Bergmeister's Papillae. Indian J Ophthalmol Case Rep 2022;2:277-8
Bergmeister's papilla (BP), also known as epipapillary veil, is usually made up of glial tissue. It is named after Austrian ophthalmologist, O. Bergmeister.
During a routine fundoscopy, a 35-year-old male was noted to have grayish-white fibrous tissue on the optic nerve head (ONH) in the left eye [Figure 1]. A diagnosis of BP was made. Optical coherence tomography (3D OCT-1 Maestro; Topcon) confirmed the presence of hyperreflective mass over ONH extending into the vitreous cavity with a clear gap between the optic disc and glial tissue [Figure 2].
|Figure 1: Fundus photo of the left eye showing a greyish white fibrous tissue over the optic nerve head|
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|Figure 2: OCT scan revealing hyperreflective glial tissue in contact with the retinal nerve fiber layer and extending into the vitreous cavity. Note a clear gap between the optic disc and glial tissue|
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| Discussion|| |
In fetal life, the hyaloid artery, which nourishes the lens through Cloquet's canal, progressively regresses from 18-weeks of gestation until it completely disappears at birth. Failure to regress can be partial or complete. The residue of its anterior portion on the posterior lens capsule is called Mittendorf's dot. The residue of the posterior portion of the hyaloid artery near the optic disc having fibrous sheath around it is called BP [Figure 3].
|Figure 3: Fundus photo showing persistent hyaloid artery in the vitreous humour with its anterior attachment, i.e., Mittendorf dot|
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Factors associated with and causing apoptosis of the hyaloid artery are still unknown. In a study, the overall prevalence of BP was found to be 0.802%. Another study using spectral-domain OCT as a tool documented that BP was present in the majority of young, normal eyes, even though it could not be observed on fundoscopy.
Though BP is a benign condition, it can be associated with microphthalmia, cataract, persistence of primitive vitreous, vitreous hemorrhages, tractional retinal detachment, or macular hole.
The presence of patent hyaloid vessels in the BP can lead to vitreous hemorrhage. The contraction of the fibro-vascular mass may exert traction on the retina causing retinal detachment or macular hole. Therefore, in a case of BP, careful examination by SD-OCT, FFA, OCT-A, and Doppler ultrasound is of considerable importance.
As in our patient, ocular findings were unremarkable except for BP, he was kept under observation and advised regular follow-up.
The authors acknowledge the guidance of Dr. V C Bhatnagar, Head of Department and Medical Superintendent, Global Hospital Institute of Ophthalmology.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Orellana J, Friedman AH. Bergmeister's papilla. In: Clinico-Pathological Atlas of Congenital Fundus Disorders. New York, NY: Springer; 1993.
Makin S. Prevalence of Bergmeister Papilla. Sch J App Med Sci 2015;3:682-3.
Sherman J, Nath S, Sadun AA, Wong V, Delgado A, Boneta J, et al
. Spectral OCT reveals Bergmeister's Papillae in the majority of normal, young patients. Invest Ophthalmol Vis Sci 2008;49:929.
Jeon H, Kim J, Kwon S. OCT angiography of persistent hyaloid artery: A case report. BMC Ophthalmol 2019;19:141.
Azrak C, Campos-Mollo E, Lledó-Riquelme M, Ibañez FA, Toldos JJM. Hemorragia vítrea asociada a arteria hialoidea persistente. Arch Soc Esp Oftalmol 2011;86:331-4.
[Figure 1], [Figure 2], [Figure 3]