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Asia-Pacific Journal of Ophthalmology... 2020Vitreous floaters are a common cause for presentation to ophthalmologists, and may significantly affect visual function. In the absence of some more serious underlying... (Review)
Review
Vitreous floaters are a common cause for presentation to ophthalmologists, and may significantly affect visual function. In the absence of some more serious underlying pathology such as uveitis, many patients may not experience significant persistent visual impairment from floaters. For some patients, the symptomatic effects of floaters may persist. For these patients, treatment options are available, of which the most commonly reported is vitrectomy. Other treatment modalities have also become more common, notably YAG vitreolysis. Selection of appropriate patients for surgery is often difficult, in part due to the relative lack of objective outcomes with which to measure both visual impairment and improvement post-procedure. Although well-tolerated, vitrectomy does carry with it risks, including iatrogenic retinal breaks, retinal detachment, and in phakic patients, subsequent cataract formation. Techniques such as small gauge vitrectomy, intraoperative examination and treatment of breaks or other worrying lesions, and careful consideration of the need for posterior vitreous detachment induction may help limit the incidence of these adverse events. For other treatment options such as YAG vitreolysis, research and clinical experience remain more limited, and as such the long-term efficacy and risks of these therapies are still unclear. Here, we review the evidence surrounding the role of vitrectomy and YAG vitreolysis in the treatment of vitreous floaters and potential means to minimize therapeutic complications.
Topics: Eye Diseases; Humans; Laser Therapy; Lasers, Solid-State; Vitrectomy; Vitreous Body
PubMed: 32097127
DOI: 10.1097/APO.0000000000000276 -
Biophysical Journal Nov 2015The efficient treatment of many ocular diseases depends on the rapid diffusive distribution of solutes such as drugs or drug delivery vehicles through the vitreous...
The efficient treatment of many ocular diseases depends on the rapid diffusive distribution of solutes such as drugs or drug delivery vehicles through the vitreous humor. However, this multicomponent hydrogel possesses selective permeability properties, which allow for the diffusion of certain molecules and particles, whereas others are immobilized. In this study, we perform an interspecies comparison showing that the selective permeability properties of the vitreous are conserved across several mammalian species. We identify the polyanionic glycosaminoglycans hyaluronic acid and heparan sulfate as two key macromolecules that establish this selective permeability. We show that electrostatic interactions between the polyanionic macromolecules and diffusing solutes can be weakened by charge screening or enzymatic glycosaminoglycan digestion. Furthermore, molecule penetration into the vitreous is also charge-dependent and only efficient as long as the net charge of the molecule does not exceed a certain threshold.
Topics: Animals; Cattle; Diffusion; Heparitin Sulfate; Humans; Hyaluronic Acid; Permeability; Sheep; Swine; Vitreous Body
PubMed: 26588575
DOI: 10.1016/j.bpj.2015.10.002 -
Oftalmologia (Bucharest, Romania : 1990) 2010
Review
Topics: Diagnosis, Differential; Eye; Eye Diseases; Humans; Radiography; Ultrasonography; Vitreous Body
PubMed: 20827904
DOI: No ID Found -
Retina (Philadelphia, Pa.) 1996
Topics: Cysts; Eye Diseases; Female; Fluorescein Angiography; Fundus Oculi; Humans; Middle Aged; Ultrasonography; Vitreous Body
PubMed: 9002141
DOI: 10.1097/00006982-199616060-00014 -
Cell Biochemistry and Biophysics Mar 2014This work aimed to consider the hazardous side effect of eye floaters treatment with Q-switched Nd:YAG laser on the protein and viscoelastic properties of the vitreous...
This work aimed to consider the hazardous side effect of eye floaters treatment with Q-switched Nd:YAG laser on the protein and viscoelastic properties of the vitreous humor, and evaluate the protective role of vitamin C against laser photo disruption. Five groups of New Zealand rabbits were divided as follows: control group for (n = 3) without any treatment, the second group (n = 9) treated with Q-switched Nd:YAG laser energy of 5 mJ × 100 pulse delivered to the anterior, middle, and posterior vitreous, respectively (n = 3 for each). The third group (n = 9) received a daily dose of 25 mg/kg body weight vitamin C for 2 weeks, and then treated with laser as the previous group. The fourth group (n = 9) treated with 10 mJ 9 50 pulse delivered to the anterior, middle, and posterior vitreous, respectively (n = 3 rabbits each). The fifth group (n = 9) received a daily dose of 25 mg/kg body weight vitamin C for 2 weeks, and then treated with laser as the previous group. After 2 weeks of laser treatment, the protein content, refractive index (RI), and the rheological properties of vitreous humor, such as consistency, shear stress, and viscosity, were determined. The results showed that, the anterior vitreous group exposed to of 5 mJ × 100 pulse and/or supplemented with vitamin C, showed no obvious change. Furthermore, all other treated groups especially for mid-vitreous and posterior vitreous humor showed increase in the protein content, RI and the viscosity of vitreous humor. The flow index remained below unity indicating the non-Newtonian behavior of the vitreous humor. Application of Q-switched Nd:YAG laser should be restricted to the anterior vitreous humor to prevent the deleterious effect of laser on the gel state of the vitreous humor.
Topics: Animals; Antioxidants; Ascorbic Acid; Lasers, Solid-State; Male; Rabbits; Refractometry; Rheology; Viscosity; Vitreous Body
PubMed: 23797611
DOI: 10.1007/s12013-013-9706-5 -
Mayo Clinic Proceedings Jul 2015
Topics: Aged; Calcium Pyrophosphate; Diagnosis, Differential; Eye Diseases; Humans; Male; Vitreous Body
PubMed: 26141340
DOI: 10.1016/j.mayocp.2014.10.015 -
Translational Vision Science &... Jul 2022To develop a machine-learning image processing model for three-dimensional (3D) reconstruction of vitreous anatomy visualized with swept-source optical coherence...
PURPOSE
To develop a machine-learning image processing model for three-dimensional (3D) reconstruction of vitreous anatomy visualized with swept-source optical coherence tomography (SS-OCT).
METHODS
Healthy subjects were imaged with SS-OCT. Scans of sufficient quality were transferred into the Fiji is just ImageJ image processing toolkit, and proportions of the resulting stacks were adjusted to form cubic voxels. Image-averaging and Trainable Weka Segmentation using Sobel and variance edge detection and directional membrane projections filters were used to enhance and interpret the signals from vitreous gel, liquid spaces within the vitreous, and interfaces between the former. Two classes were defined: "Septa" and "Other." Pixels were selected and added to each class to train the classifier. Results were generated as a probability map. Thresholding was performed to remove pixels that were classified with low confidence. Volume rendering was performed with TomViz.
RESULTS
Forty-seven eyes of 34 healthy subjects were imaged with SS-OCT. Thirty-four cube scans from 25 subjects were of sufficient quality for volume rendering. Clinically relevant vitreous features including the premacular bursa, area of Martegiani, and prevascular vitreous fissures and cisterns, as well as varying degrees of vitreous degeneration were visualized in 3D.
CONCLUSIONS
A machine-learning model for 3D vitreous reconstruction of SS-OCT cube scans was developed. The resultant high-resolution 3D movies illustrated vitreous anatomy in a manner like triamcinolone-assisted vitrectomy or postmortem dye injection.
TRANSLATIONAL RELEVANCE
This machine learning model now allows for comprehensive examination of the vitreous structure beyond the vitreoretinal interface in 3D with potential applications for common disease states such as the vitreomacular traction and Macular Hole spectrum of diseases or proliferative diabetic retinopathy.
Topics: Humans; Imaging, Three-Dimensional; Machine Learning; Tomography, Optical Coherence; Vitrectomy; Vitreous Body
PubMed: 35802368
DOI: 10.1167/tvst.11.7.3 -
Archivos de La Sociedad Espanola de... Dec 2015
Topics: Diagnosis, Differential; Female; Humans; Incidental Findings; Middle Aged; Ophthalmic Artery; Vitreous Body
PubMed: 26518100
DOI: 10.1016/j.oftal.2015.07.015 -
Journal of Biomedical Materials... May 2011We previously proposed a new strategy to replace a vitreous body with a novel foldable capsular vitreous body (FCVB). In this study, the FCVB was designed to mimic...
We previously proposed a new strategy to replace a vitreous body with a novel foldable capsular vitreous body (FCVB). In this study, the FCVB was designed to mimic natural vitreous morphology, and evaluate its physiological functions compared with traditional silicone oil substitutes, in an established rabbit model of proliferative vitreoretinopathy. We found that FCVB was a very good replacement for closely mimicking the morphology and restoring the physiological functions, such as the support, refraction, and cellular barriers, of the rabbit vitreous body. The study has provided us with a novel research and therapy strategy that could effectively mimic the morphology and physiological function of the rabbit vitreous body.
Topics: Animals; Biocompatible Materials; Biomimetics; Female; Humans; Implants, Experimental; Male; Rabbits; Silicone Oils; Vitreoretinopathy, Proliferative; Vitreous Body
PubMed: 21442743
DOI: 10.1002/jbm.b.31812 -
JAMA Ophthalmology Jan 2022
Topics: Cysts; Eye Diseases; Humans; Tomography, Optical Coherence; Vitreous Body
PubMed: 35050378
DOI: 10.1001/jamaophthalmol.2021.4681