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At least 19 recordsLinked to original sources

Molecular mechanisms of photochemically induced posterior vitreous detachment.

Vitreous gel contraction and syneresis, commonly associated with age- and disease-related posterior vitreous detachment (PVD), were induced by a hematoporphyrin (HP)-photosensitized reaction. Calf vitreous gel was irradiated by white light in the presence of HP. Gel weights of the vitreous samples after 24 h of irradiation decreased by 14%, the irradiated control without HP by 8% and the control with HP stored in the dark by 8%. No significant difference in vitreous gel compressibility was found between the irradiated controls and the irradiated samples. In separate experiments, collagen gel in a glass capillary and hyaluronic acid (HA) were irradiated with white light in the presence of HP. The control collagen gel (irradiated without HP and stored in the dark with HP) decreased in length by 0.6% after 96 h, the experimental gel with HP decreased in length by 1.3 and 1.9% after 24- and 96-hour irradiation by visible light, respectively. The irradiated HA monitored by high-performance liquid chromatography showed a molecular weight decrease in the HP-treated polymer. Because the HP-sensitized reaction predominantly produces singlet oxygen, collagen gel contraction and HA degradation, in this case, are likely caused by this active oxygen species.

Animals↗

Effect of vitreous detachment on vitreous fluorophotometry.

Twenty eyes of 17 normal subjects with or without posterior vitreous detachment (PVD) were examined to investigate the influence of various types of PVD on vitreous fluorophotometric readings. Biomicroscopic examinations of the vitreous body were performed with an El Bayadi - Kajiura preset lens, and the findings were classified according to the extent of vitreous detachment and the position of the posterior hyaloid membrane when the eye was stationary. Equivalent fluorescein concentration profiles along various directions in the vitreous cavity were obtained with vitreous fluorophotometry. The degree of PVD significantly affected the measurements. Close to the retina, fluorescein concentrations were significantly higher when the subhyaloid space was sampled than when the vitreous gel was sampled. Our findings have implications for vitreous fluorophotometric assessment of the permeability of the blood-retinal barrier.

Aged↗

Posterior vitreous detachment.

Posterior vitreous detachment is an expected consequence of aging, but it can also be the initiating cause of a retinal detachment. To understand the mechanism of posterior vitreous detachment and its sequelae, it is necessary to appreciate the anatomy of the vitreous, its development, and the pathogenesis of vitreous degeneration. This paper is a discussion of these considerations, the types of complications that may result from vitreous detachment, the proper examination of patients who present with the symptoms of vitreous detachment, and appropriate patient management.

Aging↗

Peripapillary hemorrhages in acute posterior vitreous detachment.

Posterior vitreous detachment is an important clinical finding. In addition to producing a variety of visual symptoms, it can also precipitate retinal and vitreous hemorrhages, edema of the optic disc and macula, and retinal breaks. We document the occurrence of peripapillary hemorrhages following acute posterior vitreous detachment.

Eye Diseases↗

The posterior vitreous detachment clinic: do new retinal breaks develop in the six weeks following an isolated symptomatic posterior vitreous detachment?

PURPOSE: Symptomatic posterior vitreous detachment (PVD) is sometimes associated with sight-threatening retinal tears or retinal detachment. Patients are usually reviewed twice because it is believed that retinal breaks may develop within 6 weeks of a PVD and as such the management of a PVD consumes significant resources. The aim of this study was to find the frequency of retinal breaks developing within 6 weeks of an isolated PVD using the same experienced examiner at both visits. METHOD: Patients presenting to the eye casualty with symptomatic PVD were examined by the casualty staff. Those with a retinal break or retinal detachment were referred directly for treatment and those with only a PVD were seen within 8 days in the PVD clinic. They were examined by a vitreo-retinal Fellow using indirect ophthalmoscopy and a 20 D lens with scleral indentation. The position and nature of any retinal abnormalities were noted and compared with those described in the casualty notes. Those with sight-threatening breaks were referred for treatment and the remainder were reviewed 5 weeks later when the presence of any new breaks was noted. RESULTS: One hundred and seven patients were referred to the PVD clinic over a 6-month period, of whom 2 did not have a PVD. At the first visit to the PVD clinic 6 patients had round holes anterior to the equator, 2 had equatorial horseshoe tears and 1 had lattice with holes. At the second visit, 2 additional patients had round holes anterior to the equator but in both the retina had been obscured by vitreous haemorrhage at the first visit. No patient in whom a full examination was possible at the first visit developed further retinal pathology. CONCLUSION: These results demonstrate the need to perform a full examination of the peripheral retina with scleral indentation at the time of presentation and emphasise the importance of finding a vitreous haemorrhage following a symptomatic PVD. If no retinal breaks are detected by thorough examination at presentation, further reviews, in the absence of increasing symptoms, may not be necessary.

Adult↗

[Posterior vitreous detachment].

Posterior vitreous detachments (PVDs) are common. Their complications--retinal detachment--however, are comparatively rare. PVDs without complications and those prone to complications can be differentiated biomicroscopically by morphological signs, that is by examining the posterior hyaloid and its insertion at the posterior border of the vitreous base. PVD without complications is a rhegmatogenous detachment which has been completed temporarily as well as anatomically. It has the shape of a collapsed bag whose posterior wall has been perforated and whose contents have been emptied through the hole. All other shapes of PVD are prone to complications: either an incomplete rhegmatogenous PVD with persistent vitreoretinal adhesions; or a non-rhegmatogenous PVD whose complications depend on the retinal or vascular disease which caused it.

Eye Diseases↗

Optic disc haemorrhages in posterior vitreous detachment.

Posterior vitreous detachment (PVD) is a common clinical entity but is not often associated with a significant ocular disorder. Optic disc haemorrhages are rarely associated with a PVD and are more commonly associated with other local or systemic disease. The symptoms of a PVD, combined with a careful examination of the vitreoretinal interface allows a confident diagnosis of secondary disc haemorrhage to be made. Two cases of acute symptomatic PVD complicated by disc haemorrhage are presented.

Adult↗

Prevalence of posterior vitreous detachment in high myopia.

BACKGROUND: Posterior vitreous detachment is known to develop early in high myopia. However, the prevalence of posterior vitreous detachment in relation to patient age and degree of myopia has not been studied by modern vitreous examination methods. METHODS: The vitreous conditions of 224 eyes with high myopia (> -6 diopters [D]) were examined biomicroscopically with a +90-D present lens and a Goldmann three-mirror contact lens. The vitreous conditions of 220 eyes with emmetropia (between -1 and +1 D) also were studied and served as controls. RESULTS: In high myopia, no patients 29 years of age or younger had posterior vitreous detachment. Thereafter, the prevalence of posterior vitreous detachment increased with age (i.e., 23%, 29%, 44%, and 72% in the fourth through seventh decades, respectively, and 100% of patients 70 years or older). Moreover, posterior vitreous detachment developed earlier in severe high myopia (> -10 D) than in moderate high myopia (> -6 to -10 D). In emmetropia, no patients 39 years of age or younger had posterior vitreous detachment, and its prevalence also increased with age (i.e., 8%, 23%, 44%, 74%, and 86% in the fifth through ninth decades, respectively). CONCLUSION: In high myopia, posterior vitreous detachment develops increasingly with age and degree of myopia. Although the sample size in each age group was small, the results suggested that posterior vitreous detachment may develop nearly 10 years earlier in highly myopic than in emmetropic eyes.

Adolescent↗

Acute posterior vitreous detachment: the predictive value of vitreous pigment and symptomatology.

AIM: To establish whether the presence of a retinal break can be predicted either by the presence of a positive Shafer's sign (pigment granules in the anterior vitreous) or symptomatology in patients presenting with an acute posterior vitreous detachment (PVD). METHODS: 200 eyes of 200 phakic patients with a symptomatic PVD of less than 1 month's duration underwent documentation of symptomatology and examination of the anterior vitreous for the presence of pigment granules. Indentation ophthalmoscopy was then carried out by an experienced vitreoretinal surgeon with no knowledge of the symptomatology or anterior vitreous gel examination findings. A second prospective group of 115 consecutive patients were assessed in a similar manner before primary rhegmatogenous retinal detachment repair. RESULTS: In 200 eyes presenting with an acute PVD, 25 were found to have an associated retinal break, 23 of which were also Shafer positive. In 115 eyes presenting for retinal detachment repair, 111 had an associated PVD and were found to be Shafer positive. Symptomatology was not predictive of an associated retinal break in the PVD group or in those presenting with a retinal detachment. CONCLUSION: The increased use of Shafer's sign is recommended as a valuable aid in determining which patients require urgent referral for an expert retinal examination. It is not possible to predict those patients with a retinal break secondary to PVD on the basis of symptomatology alone.

Acute Disease↗

[The incidence of retinal tears in patients with posterior vitreous detachment].

UNLABELLED: Posterior vitreous detachment (PVD) is a common finding in older patients, characterized by detachment of the posterior hyaloid membrane (PHM) from the retinal surface. The detachment of PHM normally occurs without complications, however, one has to be aware that retinal tear is its most common complication. AIM: The aim of the study was to determine the incidence of retinal tears in eyes with PVD. PATIENTS AND METHODS: A series of 40 patients (70 eyes) with PVD were included in this retrospective study. Eyes with a history of ocular trauma, surgery or intraocular inflammation were excluded. Patient charts were reviewed to collect the following information: age, sex, profession, type and duration of symptoms, best corrected visual acuity, refractive status, prior ocular disease, coincidental retinal pathology-lattice degeneration, number, type and location of retinal tears and treatment. Statistical analysis was done with the SPSS 11.0.3 software (SPSS Inc., USA). Besides descriptive statistics, Student's t-test and chi2-test were used. RESULTS: Among all study eyes with PVD, 34 (48.6%) were myopic, 24 (34.3%) hypermetropic and 12 (17.1%) emetropic; statistical analysis showed a significant difference (chi2 = 10.40, df=2, p < 0.01). In 6 (8.6%) eyes with PVD lattice malignant degeneration of peripheral retinal was diagnosed. Thorough examination of the fundus periphery revealed 16 (22.8%) eyes with PVD were found to have retinal tears, 11 (15.7%) had only one retinal tear and 5 (7.1%) two retinal tears. All retinal tears were treated with argon laser photocoagulation. Superotemporal eye quadrant was the most common localization of retinal tears (56.25%). CONCLUSION: These results indicate that thorough fundus periphery examination should be done in all patients with PVD because it can cause rather rarely though retinal tears that represent a potentially sight threatening condition.

Aged↗

The importance of qualitative vitreous examination in patients with acute posterior vitreous detachment.

OBJECTIVE: To determine whether patients with acute posterior vitreous detachment with pigmented vitreous granules or hemorrhage have a higher likelihood of retinal tear compared with those with qualitatively normal vitreous examination findings. METHODS: A multicenter cross-sectional study was performed in 3 peripheral ophthalmic clinics. Patients with acute posterior vitreous detachment were examined for the presence or absence of vitreous pigment granules, vitreous hemorrhage, and horseshoe retinal tear. RESULTS: Fifty-nine consecutive patients with acute posterior vitreous detachment met our eligibility criteria. Eight patients had a retinal tear, and thus its prevalence in our study was almost 14%. Thirteen patients (22%) had a high likelihood because they had evidence of either pigmented vitreous granules or hemorrhage. The prevalence of retinal tear in the setting of acute posterior detachment associated with vitreous hemorrhage alone, pigment alone, or vitreous hemorrhage and pigment was 54%. Patients with posterior vitreous detachment with pigmented vitreous granules or hemorrhage were significantly more likely to have a retinal tear (odds ratio, 52.0; 95% confidence interval, 5.4-497.0). Patients with a retinal tear were 7 times more likely to have pigmented vitreous granules or hemorrhage (LR + ve = 7.4, in which LR + ve indicates positive likelihood ratio; 95% confidence interval, 3.3-16.4). CONCLUSION: Patients with posterior vitreous detachment with vitreous pigment granules or hemorrhage are 52 times more likely to have a retinal tear compared with those who have normal findings on qualitative vitreous examination.

Acute Disease↗

[Posterior vitreous detachment with collapse, and peripheral retinal degeneration in the aetiology of idiopathic retinal detachment. A synapsis of clinical observations and anatomical studies (author's transl)].

The crucial aetiological factors of idiopathic retinal detachment are posterior vitreous detachment with collapse, and degenerative lesions in the fundus periphery. Posterior vitreous detachment does not imply diagnostic problems to the expert in this field. On the other hand, the peripheral retinal degenerations include wide range of lesions the clinical and pathoanatomical study of which has so far not resulted in a complete picture. The author of the present paper attempts to get closer to a clearly arranged classification and terminology of those peripheral retinal degenerations, which are of importance to the aetiology, prophylaxis and treatment of idiopathic retinal detachment.

Aged↗

Age of onset of posterior vitreous detachment.

Recently published literature on the onset of posterior vitreous detachment is reviewed here. Aging causes posterior vitreous detachment, and its prevalence increases proportionally with age. The onset of posterior vitreous detachment is associated with refractive error. Investigation of the prevalence and onset age of posterior vitreous detachment indicates that the higher the degree of myopia, the earlier the onset age. There are some reports on the onset age of posterior vitreous detachment in men compared with women. One indicates that posterior vitreous detachment occurs earlier in women, and another reports no difference. No difference has been found between blacks and whites or between whites and Japanese.

Age Factors↗

Relationship between floaters, light flashes, or both, and complications of posterior vitreous detachment.

We examined biomicroscopically the vitreous and retinal conditions of 902 consecutive symptomatic eyes (785 patients) to ascertain the relationship between floaters, light flashes, or both, and complications of posterior vitreous detachment. Of 785 patients, 785 symptomatic eyes were divided as follows: group 1, 342 eyes with floaters alone; group 2, 240 eyes with floaters and light flashes; and group 3, 203 eyes with light flashes alone. We also studied 636 asymptomatic fellow eyes. The prevalence of posterior vitreous detachment was significantly higher in groups 1 (138 of 342, 40%), 2 (214 of 240, 89%), and 3 (137 of 203, 67%) than in the asymptomatic eyes (127 of 636, 20%), in group 2 than in groups 1 and 3, and in group 3 than in group 1 (P = .01). The prevalence of retinal breaks in eyes with posterior vitreous detachment was 5% (seven of 138), 13% (27 of 214), 12% (16 of 137), and 4% (five of 127) in groups 1, 2, 3, and the asymptomatic eyes, respectively; the prevalence was significantly higher in groups 2 and 3 than in asymptomatic eyes (P = .02 and P = .04) and group 1 (P = .04 and P = .05). The prevalence of vitreous hemorrhage in eyes with retinal breaks was 71% (five of seven), 70% (19 of 27), and 6% (one of 16) in groups 1, 2, and 3, respectively. Of 117 patients with bilateral symptoms, 105 (90%) had the same symptoms and 104 (89%) had the same vitreoretinal relationship bilaterally.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗