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Eye (London, England) Jul 2002Purpose Imaging vitreous is a quest to view what is, by design, invisible. This treatise will review significant historical aspects, past and present imaging... (Review)
Review
Purpose Imaging vitreous is a quest to view what is, by design, invisible. This treatise will review significant historical aspects, past and present imaging methodologies, and imaging techniques that are currently in development for future research and clinical applications. Methods Classic and modern histologic techniques, dark-field slit microscopy, clinical slit lamp biomicroscopy, standard and scanning laser ophthalmoscopy, ultrasonography, optical coherence tomography, magnetic resonance and raman spectroscopy, and dynamic light scattering methodologies are presented. Results The best available histologic techniques for imaging vitreous are those that avoid rapid dehydration of vitreous specimens. Dark-field slit microscopy enables in vitro imaging without dehydration or tissue fixatives. Optical coherence tomography enables better in vivo visualization of the vitreo-retinal interface than scanning laser ophthalmoscopy and ultrasonography but does not image the vitreous body. Dynamic light scattering can determine the average sizes of vitreous macromolecules within the vitreous body as well as possibly image the posterior vitreous cortex once detached, while Raman spectroscopy can detect altered vitreous molecules, such as glycated collagen and other proteins in diabetic vitreopathy. Conclusions The inability to adequately image vitreous hinders a more complete understanding of its normal structure and how this changes in aging and disease. The combined use of more than one technique could provide better imaging of vitreous for future investigational and clinical purposes.
Topics: Age Factors; Aging; Diagnostic Techniques, Ophthalmological; Eye Diseases; Humans; Ophthalmoscopy; Scattering, Radiation; Vitreous Body; Vitreous Detachment
PubMed: 12101450
DOI: 10.1038/sj.eye.6700201 -
Archives D'ophtalmologie Et Revue... 1972
Review
Topics: Hemorrhage; Histocytochemistry; Humans; Hyperplasia; Microscopy, Electron; Retinal Degeneration; Retinal Detachment; Vitreous Body
PubMed: 4267200
DOI: No ID Found -
Der Ophthalmologe : Zeitschrift Der... Jul 2015Remnants of a persistent hyaloid artery can occasionally cause cataracts and traction on the retina at the posterior pole of the eye.It is the task of the... (Review)
Review
Remnants of a persistent hyaloid artery can occasionally cause cataracts and traction on the retina at the posterior pole of the eye.It is the task of the ophthalmologist to weigh up the risk of amblyopia against the risks of vitrectomy and lensectomy. The retina is primarily intact. This is different from the group of hereditary vitreoretinal dystrophies where defects in the retina and vitreous body contribute equally to the overall clinical manifestations. Familial exudative vitreoretinopathy (FEVR) of childhood is sometimes misdiagnosed as uveitis. Retinal exudates leak from enormously permeable retinal vessels and it is necessary to completely remove such abnormal vessels to stop progression. The peculiar vitreous opacities consist of paper-like veils which are stacked like onion skins. The FEVR simulates retinopathy of prematurity and other exudative vitreoretinopathies. Stickler and Wagner syndromes are associated with a high risk of rhegmatogenous retinal detachment, similar to giant retinal tears. Occasionally, extraocular manifestations, such as hyperextensive joints are indicative of a systemic connective tissue disease.The peripheral retina is mechanically weak and susceptible to tears and giant or multiple tears can occur. The prognosis is further aggravated by an elevated risk of proliferative vitreoretinopathy (PVR). It is, therefore, essential to identify the risk profile in this constellation and bear the risk of PVR in mind when selecting a treatment regimen, similar to that for giant tear retinal detachment.
Topics: Humans; Retina; Retinal Diseases; Vitreoretinopathy, Proliferative; Vitreous Body
PubMed: 26149492
DOI: 10.1007/s00347-015-0059-x -
A.M.A. Archives of Ophthalmology Sep 1957
Topics: Humans; Vitreous Body
PubMed: 13457541
DOI: 10.1001/archopht.1957.00940010467024 -
Optometry Clinics : the Official... 1992Posterior 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... (Review)
Review
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.
Topics: Aging; Eye Diseases; Fundus Oculi; Humans; Retinal Detachment; Retinal Perforations; Vitreous Body; Vitreous Hemorrhage
PubMed: 1463911
DOI: No ID Found -
Eye (London, England) 1992
Topics: Collagen; Humans; Vitreous Body
PubMed: 1289127
DOI: 10.1038/eye.1992.118 -
American Journal of Ophthalmology Aug 2016To report novel vitreous body microarchitecture findings using high-resolution spectral-domain optical coherence tomography (HR-SD-OCT).
PURPOSE
To report novel vitreous body microarchitecture findings using high-resolution spectral-domain optical coherence tomography (HR-SD-OCT).
DESIGN
Prospective, cross-sectional study.
METHODS
Horizontal and vertical retinal cross-sectional images that were 10 mm long were acquired from 17 eyes of 17 young healthy volunteers using HR-SD-OCT with enhanced vitreous imaging (EVI). Images were acquired through the fovea, upper vessel arcade, and lower vessel arcade.
RESULTS
Three new findings on vitreous body microarchitecture were found. First, material located between the retina and posterior vitreous cortex was easily detected in 90% of upper and lower vessel arcade scans. Most scans contained hyperreflective dots and multilayered hyperreflective lines around the detached vitreous cortex. Second, a lamellar structure was observed in the vitreous body in 70%-80% of all scans, excluding vertical scans of the upper arcade vessel area. Third, tubular zones of hypodensity were detected in >80% of scans, excluding horizontal scans of the macula. Interestingly, the location of tubular zones of hypodensity seemed to correspond with the location of retinal vessels. Subject age, refractive error, and axial length were not significantly different in scans with and without material between the retina and vitreous, lamellar structures, and tubular zones of hypodensity.
CONCLUSIONS
The microarchitecture of the vitreous body can be visualized using HR-SD-OCT and EVI.
Topics: Adult; Cross-Sectional Studies; Female; Humans; Male; Middle Aged; Prospective Studies; Tomography, Optical Coherence; Vitreous Body; Young Adult
PubMed: 27163233
DOI: 10.1016/j.ajo.2016.04.021 -
Journal Francais D'ophtalmologie Feb 1978
Topics: Humans; Vitreous Body
PubMed: 149805
DOI: No ID Found -
Current Opinion in Ophthalmology May 2021Symptomatic vitreous opacities are increasingly recognized as a significant burden to patient well-being. There is growing interest in the use of vitrectomy or laser... (Review)
Review
PURPOSE OF REVIEW
Symptomatic vitreous opacities are increasingly recognized as a significant burden to patient well-being. There is growing interest in the use of vitrectomy or laser treatment to address these problems. This review is intended to update current assessment, management, and risks of treatment for persistent severely symptomatic vitreous opacities.
RECENT FINDINGS
Despite studies showing the value of quantitative ultrasound, reading speed measurements, and contrast sensitivity for assessing dysfunction caused by vitreous opacities, the decision of whether to proceed with surgery remains a very subjective, clinical one. Visual Function Questionnaire-25 score studies show a very large improvement postvitrectomy consistent with relief from symptoms and patient satisfaction. The risk of retinal tear and detachment appears to be higher than in most conditions treated with vitrectomy.
SUMMARY
Vitrectomy for the management of severe vitreous opacities is increasingly accepted because of the tremendous relief of symptoms reported by patients. The risks of retinal tear and detachment remain a concern, particularly in patients who have an attached posterior hyaloid. Yttrium-aluminum-garnet laser treatment of floaters may offer benefit in a subset of patients but appears to be less definitive than vitrectomy, and also may carry significant risk.
Topics: Eye Diseases; Humans; Laser Therapy; Lasers, Solid-State; Vitrectomy; Vitreous Body
PubMed: 33710011
DOI: 10.1097/ICU.0000000000000752 -
Developments in Ophthalmology 2009There is an increasing interest in the concept of using enzymes to induce vitreoretinal separation and/or modulate the structure of the vitreous as an aid to, or... (Review)
Review
There is an increasing interest in the concept of using enzymes to induce vitreoretinal separation and/or modulate the structure of the vitreous as an aid to, or replacement for, mechanical vitrectomy. In order to understand how these enzymes work and to develop new and better therapeutics, knowledge of vitreous structure at a molecular and supramolecular level is key. The vitreous like many extracellular matrices has a composite structure with a network of collagen fibrils, that is essential for the gel structure, and a glycosaminoglycan network composed predominantly of hyaluronan that fills the spaces between the collagen fibrils and helps to inflate the matrix. The collagen fibrils are very resistant to proteolytic degradation so these do not make a good target for pharmacological vitreolysis, but degradation of the hyaluronan facilitates the dispersal of vitreous haemorrhage. The molecular mechanisms underlying postbasal vitreoretinal adhesion are poorly understood but it is likely that intermediary molecules that link cortical vitreous collagen fibrils to the inner limiting lamina play a major role. Furthermore, it is apparent that proteolytic enzymes such as plasmin fragment these linking molecules and thereby facilitate vitreoretinal disinsertion.
Topics: Fibrinolytic Agents; Glycosaminoglycans; Glycoside Hydrolases; Humans; Injections; Microscopy, Electron; Retinal Diseases; Vitreous Body
PubMed: 19494647
DOI: 10.1159/000223939