Hirotaka Itakura1, Shoji Kishi. 1. Department of Ophthalmology, Gunma University, School of Medicine, Maebashi, Japan.
Abstract
IMPORTANCE: Development of posterior vitreous detachment (PVD) plays an important role in vitreomacular diseases. Spectral-domain optical coherence tomography (SD-OCT) with noise reduction can visualize a posterior precortical vitreous pocket (PPVP) and classify PVD stages according to the state of the posterior wall of the PPVP. OBJECTIVE: To describe the role of the PPVP in early-stage PVDs in healthy individuals. DESIGN, SETTING, AND PARTICIPANTS: We performed biomicroscopy and SD-OCT in the right eyes of 368 healthy volunteers (188 males and 180 females; mean [SD] age, 57.1 [19.4] years; range, 12-89 years). RESULTS: The condition of the posterior wall of the PPVP was classified into stages according to the biomicroscopic findings and SD-OCT images: stage 0, no PVD with PPVP (134 eyes; mean [SD] subject age, 38.7 [16.5] years; range, 12-76 years); stage 1, paramacular PVD with PPVP (47 eyes; mean age, 55.2 [10.3] years; range, 36-77 years); stage 2, perifoveal PVD with PPVP (27 eyes; mean age, 62.0 [8.7] years; range, 46-81 years); stage 3, vitreofoveal separation with persistent attachment to the optic disc (19 eyes; mean age, 65.8 [6.2] years; range, 55-80 years; stage 3a, vitreofoveal separation with an intact posterior wall of the PPVP in 12 eyes; stage 3b, vitreofoveal separation with a defect in the posterior wall of the PPVP in 7 eyes; and stage 4, complete PVD (141 eyes; mean age, 73.2 [8.3] years; range, 48-89 years). MAIN OUTCOMES AND MEASURES: Ages in each PVD stage. CONCLUSIONS AND RELEVANCE: The posterior wall of the PPVP initially detaches at the paramacular area and extends to the perifoveal area, which results in a perifoveal PVD. A vitreofoveal detachment may develop with or without a defect in the PPVP. When the vitreous detaches from the optic disc, a complete PVD develops. An anatomical feature of the PPVP may play a role in the development of a perifoveal PVD.
IMPORTANCE: Development of posterior vitreous detachment (PVD) plays an important role in vitreomacular diseases. Spectral-domain optical coherence tomography (SD-OCT) with noise reduction can visualize a posterior precortical vitreous pocket (PPVP) and classify PVD stages according to the state of the posterior wall of the PPVP. OBJECTIVE: To describe the role of the PPVP in early-stage PVDs in healthy individuals. DESIGN, SETTING, AND PARTICIPANTS: We performed biomicroscopy and SD-OCT in the right eyes of 368 healthy volunteers (188 males and 180 females; mean [SD] age, 57.1 [19.4] years; range, 12-89 years). RESULTS: The condition of the posterior wall of the PPVP was classified into stages according to the biomicroscopic findings and SD-OCT images: stage 0, no PVD with PPVP (134 eyes; mean [SD] subject age, 38.7 [16.5] years; range, 12-76 years); stage 1, paramacular PVD with PPVP (47 eyes; mean age, 55.2 [10.3] years; range, 36-77 years); stage 2, perifoveal PVD with PPVP (27 eyes; mean age, 62.0 [8.7] years; range, 46-81 years); stage 3, vitreofoveal separation with persistent attachment to the optic disc (19 eyes; mean age, 65.8 [6.2] years; range, 55-80 years; stage 3a, vitreofoveal separation with an intact posterior wall of the PPVP in 12 eyes; stage 3b, vitreofoveal separation with a defect in the posterior wall of the PPVP in 7 eyes; and stage 4, complete PVD (141 eyes; mean age, 73.2 [8.3] years; range, 48-89 years). MAIN OUTCOMES AND MEASURES: Ages in each PVD stage. CONCLUSIONS AND RELEVANCE: The posterior wall of the PPVP initially detaches at the paramacular area and extends to the perifoveal area, which results in a perifoveal PVD. A vitreofoveal detachment may develop with or without a defect in the PPVP. When the vitreous detaches from the optic disc, a complete PVD develops. An anatomical feature of the PPVP may play a role in the development of a perifoveal PVD.
Authors: Dong Heun Nam; Philip J Desouza; Paul Hahn; Vincent Tai; Monica B Sevilla; Du Tran-Viet; David Cunefare; Sina Farsiu; Joseph A Izatt; Cynthia A Toth Journal: Retina Date: 2015-08 Impact factor: 4.256
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