Аcute posterior vitreous detachment
DOI: 10.32364/2311-7729-2022-22-4-247-253
P.L. Volodin, S.I. Belyanina
S. Fyodorov Eye Microsurgery Federal State Institution, Moscow, Russian Federation
The detachment of the posterior hyaloid membrane (posterior vitreous detachment /PVD/) means the separation of the posterior vitreous cortex from the internal limiting membrane of the retina and the optic disc. Traditionally, PVD is considered as a physiological process associated with the involutional changes of the vitreous body. In most cases, the early stages of acute PVD are asymptomatic. Patients do not seek for medical care until an acute condition occurs along with the development of typical symptoms. It happens when the posterior hyaloid membrane completely separates from the retina and the optic disc, or when complications of this process develop, such as hemorrhages in the vitreous and retina, retinal breaks/tears and detachment, and macular lesions. Taking into consideration the spontaneous PVD onset and the risk of various complications, it is necessary to conduct a thorough research of the etiology and pathogenesis of this process, identify potential pre disposing and triggering factors, and to define tactics of patient management, timely detection and treatment of complications. It is important to assess the informational value of special instrumental methods of patient examination, such as B-scan ultrasound imaging and optical coherence tomography. These methods open new perspectives for verifying the diagnostic accuracy, revealing complications, visualizing residual vitreoretinal adhesions, and offering tactics for further patient management.
Keywords: acute posterior vitreous detachment, posterior hyaloid membrane, peripheral retinal breaks/tears, rhegmatogenous retinal detachment, vitreomacular traction syndrome, B-scan ultrasonography, optical coherence tomography.
For citation: Volodin P.L., Belyanina S.I. Аcute posterior vitreous detachment. Russian Journal of Clinical Ophthalmology. 2022;22(4):247–253 (in Russ.). DOI: 10.32364/2311-7729-2022-22-4-247-253.
About the authors:
Pavel L. Volodin — Dr. Sc. (Med.), Head of the Department of Retinal Laser Surgery, S. Fyodorov Eye Microsurgery Federal State Institution; 59a, Beskudnikovskiy blvd, Moscow, 127486, Russian Federation; ORCID iD 0000-0003-1460-9960.
Sofia I. Belyanina — postgraduate student of the Department of Retinal Laser Surgery, S. Fyodorov Eye Microsurgery Federal State Institution; 59a, Beskudnikovskiy blvd, Moscow, 127486, Russian Federation; ORCID iD 0000-0002-5982-9396.
Contact information: Sofia I. Belyanina, e-mail: sofiabelyanina00@mail.ru.
Financial Disclosure: no authors have a financial or property interest in any material or method mentioned.
There is no conflict of interests.
Received 09.03.2022.
Revised 01.04.2022.
Accepted 26.04.2022.
2. Kislitsyna N.M., Novikov S.V., Kolesnik S.V., Veselkova M.P. Anatomical and topographical features of anterior vitreous cortex. Fyodorov Journal of Ophthalmic Surgery. 2017;1:66–71 (in Russ.). DOI: 10.25276/0235-4160-2017-1-66-71.
3. Sebag J. Vitreous: In Health and Disease. New York: Springer; 2014:134–142. DOI: 10.1007/978-1-4939-1086-1.
4. Lyskin P.V. New Data of Mechanism in Vitreoretinal Adhesion and Posterior Vitreous Detachment in Humans. Russian ophthalmology of children. 2019;2:57–62 (in Russ.). DOI: 10.25276/2307-6658-2019-2-57-62.
5. Fincham G.S., James S., Spickett C. et al. Posterior Vitreous Detachment and the Posterior Hyaloid Membrane. Ophthalmology. 2018;125(2):227–236. DOI: 10.1016/j.ophtha.2017.08.001.
6. Boyko E.V., Suetov A.A., Maltsev D.S. Posterior hyaloid membrane detachment: concept, morbility, nosology, clinical picture and possible reasons. Ophthalmology Journal. 2009;2(3):39–46 (in Russ.).
7. Johnson M.W. Perifoveal vitreous detachment and its macular complications. Trans Am Ophthalmol Soc. 2005;103:537–567. PMID: 17057817.
8. Foos R.Y. Posterior vitreous detachment. Trans Am Acad Ophthalmol Otolaryngol. 1972;76(2):480–497. PMID: 4582684.
9. Hruby K., Posner A. Slitlamp examination of vitreous and retina. Baltimore: Williams and Wilkins; 1967.
10. Uchino E., Uemura A., Ohba N. Initial stages of posterior vitreous detachment in healthy eyes of older persons evaluated by optical coherence tomography. Arch Ophthalmol. 2001;119(10):1475–1479. DOI: 10.1001/archopht.119.10.1475.
11. Kakehashi A., Takezawa M., Akiba J. Classification of posterior vitreous detachment. Clin Ophthalmol. 2014;8:1–10. DOI: 10.2147/OPTH.S54021.
12. Seider M.I., Conell C., Melles R.B. Complications of Acute Posterior Vitreous Detachment. Ophthalmology. 2022;129(1):67–72. DOI: 10.1016/j.ophtha.2021.07.020.
13. Yonemoto J., Ideta H., Sasaki K. et al. The age of onset of posterior vitreous detachment. Graefes Arch Clin Exp Ophthalmol. 1994;232(2):67–70. DOI: 10.1007/BF00171665.
14. Hayashi K., Sato T., Manabe S.I., Hirata A. Sex-related differences in the progression of posterior vitreous detachment with age. Ophthalmology Retina. 2019;3(3):237–243. DOI: 10.1016/j.oret.2018.10.017.
15. Bond-Taylor M., Jakobsson G., Zetterberg M. Posterior vitreous detachment — prevalence of and risk factors for retinal tears. Clin Ophthalmol. 2017;11:1689–1695. DOI: 10.2147/OPTH.S143898.
16. Akiba J. Prevalence of posterior vitreous detachment in high myopia. Ophthalmology. 1993;100(9):1384–1388. DOI: 10.1016/s0161-6420(93)31471-5.
17. Morita H., Funata M., Tokoro T. A clinical study of the development of posterior vitreous detachment in high myopia. Retina. 1995;15(2):117–124. DOI: 10.1097/00006982-199515020-00005.
18. Hayashi K., Manabe S.I., Hirata A., Yoshimura K. Posterior Vitreous Detachment in Highly Myopic Patients. Invest Ophthalmol Vis Sci. 2020;61(4):33. DOI: 10.1167/iovs.61.4.33.
19. Nishikawa Y., Morishita S., Horie T. et al. A comparison of sex steroid concentration levels in the vitreous and serum of patients with vitreoretinal diseases. PLoS One. 2017;12(7):e0180933. DOI: 10.1371/journal.pone.0180933.
20. Van Deemter M., Ponsioen TL., Bank R.A. et al. Pentosidine accumulates in the aging vitreous body: a gender effect. Exp Eye Res. 2009;88(6):1043–1050. DOI: 10.1016/j.exer.2009.01.004.
21. Chuo J.Y., Lee T.Y., Hollands H. et al. Risk factors for posterior vitreous detachment: a case-control study. Am J Ophthalmol. 2006;142(6):931–937. DOI: 10.1016/j.ajo.2006.08.002.
22. Hayashi K., Sato T., Manabe S.I. et al. Posterior vitreous detachment in patients with diabetes mellitus. Jpn J Ophthalmol. 2020;64(2):187–195. DOI: 10.1007/s10384-020-00720-9.
23. Hendrikse F., Yeo K.T. Die Rolle des Glaskörpers in der diabetischen Retinopathie [Role of the vitreous body in diabetic retinopathy]. Klin Monbl Augenheilkd. 1993;203(5):319–323 (in German.). DOI: 10.1055/s-2008-1045684.
24. Garcia G.A., Khoshnevis M., Yee K.M.P. et al. Degradation of Contrast Sensitivity Function Following Posterior Vitreous Detachment. Am J Ophthalmol. 2016;172:7–12. DOI: 10.1016/j.ajo.2016.09.005.
25. Abdolrahimzadeh S., Piraino D.C., Scavella V. et al. Spectral domain optical coherence tomography and B-scan ultrasonography in the evaluation of retinal tears in acute, incomplete posterior vitreous detachment. BMC Ophthalmology. 2016;16:60. DOI: 10.1186/s12886-016-0242-0.
26. Federal clinical guidelines. Peripheral retinal degeneration. 2019. (Electronic resource.) URL: http://avo-portal.ru/doc/fkr/item/326-perifericheskie-degeneratsii-setchatki (access date: 01.03.2021) (in Russ.).
27. Uhr J.H., Obeid A., Wibbelsman T.D. et al. Delayed Retinal Breaks and Detachments after Acute Posterior Vitreous Detachment. Ophthalmology. 2020;127(4):516–522. DOI: 10.1016/j.ophtha.2019.10.020.
28. Overdam K.A., Bettink-Remeijer M.W., Klaver C.C. et al. Symptoms and findings predictive for the development of new retinal breaks. Arch Ophthalmol. 2005;123(4):479–484. DOI: 10.1001/archopht.123.4.479.
29. Coffee R.E., Westfall A.C., Davis G.H. et al. Symptomatic Posterior Vitreous Detachment and the Incidence of Delayed Retinal Breaks: Case Series and Meta-analysis. Am J Ophthalmol. 2007;144(3):409–413. DOI: 10.1016/j.ajo.2007.05.002.
30. Gishti O., van den Nieuwenhof R., Verhoekx J., van Overdam K. Symptoms related to posterior vitreous detachment and the risk of developing retinal tears: a systematic review. Acta Ophthalmol. 2019;97(4):347–352. DOI: 10.1111/aos.14012.
31. Lyskin P.V., Zgoba M.I. Vitreomacular traction. Theoretical and practical aspects of treatment. Russian ophthalmology of children. 2019;1:43–51 (in Russ.). DOI: 10.25276/2307-6658-2019-1-43-51.
32. Gabriel R.S., Boisvert C.J., Mehta M.C. Review of Vitreopapillary Traction Syndrome. Neuroophthalmology. 2020;44(4):213–218. DOI: 10.1080/01658107.2020.1725063.
33. Flaxel C.J., Adelman R.A., Bailey S.T. et al. Idiopathic Epiretinal Membrane and Vitreomacular Traction Preferred Practice Pattern. Ophthalmology. 2020;127(2):145–183. DOI: 10.1016/j.ophtha.2019.09.022.
34. Sandinha M.T., Kotagiri A.K., Owen R.I. et al. Accuracy of B-scan ultrasonography in acute fundus obscuring vitreous hemorrhage using a standardized scanning protocol and a dedicated ophthalmic ultrasonographer. Clin Ophthalmol. 2017;11:1365–1370. DOI: 10.2147/OPTH.S133938.
35. Lorenzo-Carrero J., Perez-Flores I., Cid-Galano M. et al. B-scan ultrasonography to screen for retinal tears in acute symptomatic age-related posterior vitreous detachment. Ophthalmology. 2009;116(1):94–99. DOI: 10.1016/j.ophtha.2008.08.040.
36. Kicova N., Bertelmann T., Irle S. et al. Evaluation of a posterior vitreous detachment: a comparison of biomicroscopy, B-scan ultrasonography and optical coherence tomography to surgical findings with chromodissection. Acta Ophthalmol. 2012;90(4):264–268. DOI: 10.1111/j.1755-3768.2011.02330.x.
37. Casswell E.J., Abou Ltaif S., Carr T. et al. Widefield spectral-domain optical coherence tomography imaging of peripheral round retinal holes with or without retinal detachment. Retina. 2019;39(6):1047–1053. DOI: 10.1097/IAE.0000000000002133.
38. Doga A.V., Volodin P.L., Kryl L.A. et al. Diagnostic value of modern non-invasive methods of peripheral vitreoretinal interface in the choice of treatment tactics of patients with valvular ruptures of the retina. Prakticheskaya meditsina. 2017;9(110):144–1462017 (in Russ.).
39. Berglin L., Stenkula S., Crafoord S., Ohrström A. A new technique of treating rhegmatogenous retinal detachment using the Q-switched Nd:YAG laser. Ophthalmic Surg. 1987;18(12):890–892. PMID: 3444600.
40. Akopyan V.S., Pivovarov N.N., Glukhoded S.V., Gurova I.V. The first experience of laser retinal surgery. Vestnik Oftalmologi. 1989;105(3):28–30 (in Russ.).
41. Doga A.V., Volodin P.L., Kryl L.A. et al. Laser Retinotomy with "Ultra Q Reflex" System for the Prevention of Rhegmatogenous Retinal Detachment due to the Peripheral Horseshoe Tears. Ophthalmology in Russia. 2018;15(1):24–31 (in Russ.). DOI: 10.18008/1816-5095-2018-1-24-31.
42. Shaimova V.A., Shaimov T.B., Shaimov R.B. et al. Preventive laser treatment of tractional symptomatic retinal flap tears: long-term outcomes. Vestnik Oftalmologii. 2020;136(3):32–38 (in Russ.). DOI: 10.17116/oftalma202013603132.
43. Feltgen N., Walter P. Rhegmatogenous retinal detachment — an ophthalmologic emergency. Deutsches Arzteblatt international. 2014;111(1–2):12–22. DOI: 10.3238/arztebl.2014.0012 2014).
44. Sebag J. Reassessing the surgical treatment of floaters: Pars plana vitrectomy remains the safest and best approach. Retina Today. 2014;3:64–67.
45. Broadhead G.K., Hong T., Chang A.A. To Treat or Not to Treat: Management Options for Symptomatic Vitreous Floaters. Asia Pac J Ophthalmol (Phila). 2020;9(2):96–103. DOI: 10.1097/APO.0000000000000276.
46. Tripathy K. Is Floaterectomy Worth the Risks? Asia-Pacific Journal of Ophthalmology. 2017;6(3):303–304. DOI: 10.22608/APO.201738.
47. Doga A.V., Buryakov D.A., Normaev B.A. Clinical and functional results of YAG-laser vitreolysis in different types of vitreous floaters treatment. Fyodorov Journal of Ophthalmic Surgery. 2019;1:44–49 (in Russ.). DOI: 10.25276/0235-4160-2019-1-44-49.
48. De Smet M.D., Gandorfer A., Stalmans P. et al. Microplasmin intravitreal administration in patients with vitreomacular traction scheduled for vitrectomy: the MIVI I trial. Ophthalmology. 2009;116(7):1349–1355. DOI: 10.1016/j.ophtha.2009.03.051.
49. Kuppermann B.D. The Phase III MIVI-TRUST Clinical Trial Data: Subgroup Responder Analysis of a Single Intravitreal Injection of Ocriplasmin in patients with Vitreomacular Traction. Invest Ophthalmol Vis Sci. 2012;53(14):2754.
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