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International Journal of Retina and... 2020To objectively evaluate YAG laser vitreolysis for symptomatic vitreous floaters using color photo imaging.
BACKGROUND
To objectively evaluate YAG laser vitreolysis for symptomatic vitreous floaters using color photo imaging.
METHODS
In this interventional and prospective study, 32 eyes of 32 patients with symptomatic vitreous floaters secondary to posterior vitreous detachment (PVD) were treated with a single session of yttrium aluminum garnet (YAG) laser. Primary outcomes were objective and subjective changes measured by masked grading of color fundus photographs and National Eye Institute Visual Functioning Questionnaire 25 (NEI VFQ-25), respectively. Secondary outcomes included Early Treatment Diabetic Retinopathy Study (ETDRS), best-corrected visual acuity (BCVA) and adverse events. Wilcoxon signed-rank test was used to analyze the results of the objective and subjective assessments at each time point. P < 0.05 was considered statistically significant.
RESULTS
Thirty-two patients (32 eyes; 13 men and 19 women) with symptomatic vitreous floaters were enrolled in this study (mean age: 59.4 years). All study patients were followed up for 6 months. Following the laser vitreolysis, there was a statistically significant improvement in both the near visual function (z = - 2.97; p = 0.003; r = 0.633) and visual disturbance rate (z = - 3.97; p < 0.001; r = 0.84). Distance visual function did not show statistically significant difference after the laser procedure (p = 1.00). Color fundus photograph did reveal vitreous opacity improvement over time in 93.7% of study eyes (partial improvement in 37.5% and total improvement in 56.2% of study eyes). During the follow-up period, recurrence of vitreous floaters, BCVA deterioration and adverse events were not observed.
CONCLUSIONS
YAG laser vitreolysis decreased the amount of vitreous floaters opacities seen on color fundus imaging and improved related symptoms according to the NEI VFQ-25 responses.
PubMed: 31988795
DOI: 10.1186/s40942-019-0205-8 -
Investigative Ophthalmology & Visual... May 2024Vision-degrading myodesopsia (VDM) from vitreous floaters significantly degrades vision and impacts visual quality of life (VQOL), but the relationship to light...
PURPOSE
Vision-degrading myodesopsia (VDM) from vitreous floaters significantly degrades vision and impacts visual quality of life (VQOL), but the relationship to light scattering is poorly understood. This study compared in vitro measures of light scatter and transmission in surgically excised human vitreous to preoperative indexes of vitreous structure, visual function, and VQOL.
METHODS
Pure vitreous collected during vitrectomy from 8 patients with VDM had wide-angle straylight measurements and dark-field imaging, performed within 36 hours of vitrectomy. Preoperative VQOL assessment with VFQ-25, contrast sensitivity (CS) measurements with Freiburg acuity contrast testing, and quantitative ultrasonography were compared to light scattering and transmission in vitro.
RESULTS
All indices of vitreous echodensity in vivo correlated positively with straylight at 0.5° (R = 0.708 to 0.775, P = 0.049 and 0.024, respectively). Straylight mean scatter index correlated with echodensity (R = 0.71, P = 0.04) and VQOL (R = -0.82, P = 0.0075). Dark-field measures in vitro correlated with degraded CS in vivo (R = -0.69, P = 0.04). VQOL correlated with straylight mean scatter index (R = -0.823, P = 0.012).
CONCLUSIONS
Increased vitreous echodensity in vivo is associated with more straylight scattering in vitro, validating ultrasonography as a clinical surrogate for light scattering. Contrast sensitivity in vivo is more degraded in the presence of dark-field scattering in vitro and VQOL is decreased in patients whose vitreous has increased light scattering. These findings could form the basis for the development of optical corrections for VDM or support new laser treatments, as well as novel pharmacotherapy.
Topics: Humans; Vitreous Body; Female; Male; Scattering, Radiation; Middle Aged; Light; Visual Acuity; Vitrectomy; Contrast Sensitivity; Aged; Quality of Life; Vision Disorders; Adult; Ultrasonography; Eye Diseases
PubMed: 38727692
DOI: 10.1167/iovs.65.5.20 -
Asia-Pacific Journal of Ophthalmology... 2016This study aimed to objectively grade the perception of subclinical floaters in an asymptomatic cohort. (Observational Study)
Observational Study
PURPOSE
This study aimed to objectively grade the perception of subclinical floaters in an asymptomatic cohort.
DESIGN
A prospective observational cohort study.
METHODS
One hundred eighty-two volunteers (49 men, 133 women) with ages ranging from 17.7 to 78.6 years were recruited for floater assessment. Participants were assessed by a light box and by vitreoscope, after which they graded the floaters using a graphic classification system. They also completed a questionnaire to estimate the impact of floaters on daily life. In addition, biometric and refractive data were documented for all participants.
RESULTS
Using the light box method, 67.6% of participants reported seeing transparent floaters, which increased to 84.1% when using the vitreoscope. Opaque floaters were seen by 15.9% (light box) and 6.5% (vitreoscope). Reported levels of floater discomfort varied between participants, with 80.2% of participants reporting no discomfort and 6.6% reporting moderate to manifest discomfort. The perceived discomfort was weakly correlated with the amount of visualized floaters (light box: Pearson r = 0.323, P < 0.001; vitreoscope: r = 0.174, P < 0.001). Both floater perception and discomfort increased with age (r = 0.203, P = 0.006; r = 0.194, P = 0.009, respectively), although neither changed with axial length or refraction (P = 0.131, P = 0.070, respectively).
CONCLUSIONS
The light box and the vitreoscope demonstrate that subclinical floaters are very common, even in nonsymptomatic subjects. The amount of perceived floaters in this cohort correlates only weakly with floater-related discomfort.
Topics: Adolescent; Adult; Age Factors; Aged; Eye Diseases; Female; Humans; Male; Middle Aged; Prospective Studies; Refraction, Ocular; Surveys and Questionnaires; Visual Acuity; Vitreous Body; Young Adult
PubMed: 26918903
DOI: 10.1097/APO.0000000000000189 -
Survey of Ophthalmology 2020Vitreous floaters are common, related to age, myopia, genetic predisposition, and infiltration of the vitreous body. A subset of patients report symptoms impacting their... (Review)
Review
Vitreous floaters are common, related to age, myopia, genetic predisposition, and infiltration of the vitreous body. A subset of patients report symptoms impacting their quality of vision. Treatment with laser vitreolysis, the use of an Nd:YAG laser to vaporize the collagenous vitreous opacities appears to be used more frequently; however, data regarding long-term safety and effectiveness are lacking. We present currently available data regarding efficacy and safety, as well as additional considerations. Laser vitreolysis of symptomatic floaters should not be routinely performed without additional studies documenting its safety and long-term efficacy. Ideally, the procedure would be effective in most patients and be approved by the Food and Drug Administration based on the results of a Food and Drug Administration registration trial before widespread adoption.
Topics: Eye Diseases; Humans; Laser Therapy; Lasers, Solid-State; Visual Acuity; Vitrectomy; Vitreous Body
PubMed: 32135173
DOI: 10.1016/j.survophthal.2020.02.007 -
Survey of Ophthalmology 2019Asteroid hyalosis is a relatively common cause of vitreous opacities, which is possibly associated with diabetes mellitus and hereditary pigmentary retinopathies. We... (Review)
Review
Asteroid hyalosis is a relatively common cause of vitreous opacities, which is possibly associated with diabetes mellitus and hereditary pigmentary retinopathies. We review the history, epidemiology, and biochemistry of asteroid hyalosis, as well as its relationship with ocular and systemic conditions. We describe imaging modalities used for diagnostic evaluations in cases of severe asteroid hyalosis and propose hypotheses regarding its lack of significant effects on vision. We discuss cataract surgery in patients with asteroid hyalosis and the selection of intraocular lenses for implantation.
Topics: Cataract Extraction; Diagnostic Techniques, Ophthalmological; Eye Diseases; Humans; Lens Implantation, Intraocular; Lenses, Intraocular; Vision Disorders; Vitreous Body
PubMed: 30707924
DOI: 10.1016/j.survophthal.2019.01.008 -
Case Reports in Ophthalmology 2022This study aimed to report the risk factors and treatment outcomes of visually disturbing vitreous opacities after neodymium-doped yttrium aluminum garnet (Nd:YAG) laser...
This study aimed to report the risk factors and treatment outcomes of visually disturbing vitreous opacities after neodymium-doped yttrium aluminum garnet (Nd:YAG) laser posterior capsulotomy. This was a retrospective observational case series study that included 6 patients who underwent vitrectomy for vitreous opacities after Nd:YAG laser capsulotomy. The patients' medical records from January 2017 to June 2020 were reviewed. Seven eyes of 6 patients who underwent pars plana vitrectomy for visually disturbing vitreous opacities were included in this study. The mean duration between Nd:YAG capsulotomy and vitrectomy was 8.57 ± 1.27 months. The posterior capsule opacification was proliferative with a pearl form in all patients. Visual acuity improved significantly after vitrectomy. Nd:YAG laser causes visually disturbing vitreous opacities. Vitrectomy was an effective treatment for these opacities.
PubMed: 35950022
DOI: 10.1159/000525335 -
Clinical & Experimental Optometry Aug 2022Contrast thresholds under photopic and mesopic luminance conditions are compromised in subjects with vitreous degeneration. A plausible explanation is needed for the...
CLINICAL RELEVANCE
Contrast thresholds under photopic and mesopic luminance conditions are compromised in subjects with vitreous degeneration. A plausible explanation is needed for the visual discomfort expressed by patients suffering from symptomatic vitreous degeneration.
BACKGROUND
The current study investigates the effect of symptomatic vitreous degeneration on photopic and mesopic contrast at high spatial frequencies.
METHODS
An age-matched sample of 115 subjects, comprising 30 subjects with symptomatic vitreous floaters (cases) and 85 healthy subjects (controls), was included in this study. Visual acuity and flicker thresholds were measured for all participants. Photopic and mesopic functional contrast thresholds at 10 cycles per degree were measured for all participants to assess the effect of floaters on contrast. Further, to determine the effect of posterior vitreous detachment on contrast, the sample was divided into three groups: cases with posterior vitreous detachment (n = 12); cases without posterior vitreous detachment (n = 18); and controls (n = 85), and their contrast thresholds were compared.
RESULTS
Photopic and mesopic contrast thresholds were lower by 37.4% and 27.5%, respectively, when the cases were compared with the controls (p = 0.028 and p < 0.001 for photopic and mesopic contrast thresholds, respectively). Photopic contrast was lower by 64.0% in cases with posterior vitreous detachment compared with controls (p = 0.001). Compared with controls, mesopic contrast was lower in cases with posterior vitreous detachment and in cases without posterior vitreous detachment by 30.3% and 25.6%, respectively (p = 0.014 and p = 0.017 for cases with and without posterior vitreous detachment, respectively).
CONCLUSION
: Subjects with vitreous degeneration have diminished photopic and mesopic contrast thresholds compared with controls. This finding highlights the negative impact of vitreous degeneration on the quality of vision.
Topics: Color Vision; Contrast Sensitivity; Humans; Mesopic Vision; Vision Disorders; Vitreous Detachment
PubMed: 34751082
DOI: 10.1080/08164622.2021.1981116 -
Journal of Ophthalmology 2017To evaluate the degree of psychological distress in symptomatic vitreous floater patients and to evaluate whether these psychological factors are associated with the...
PURPOSE
To evaluate the degree of psychological distress in symptomatic vitreous floater patients and to evaluate whether these psychological factors are associated with the severity of discomfort associated with vitreous floaters.
METHODS
We recruited 61 patients with symptomatic vitreous floaters and 34 controls. The degree of posterior vitreous detachment (PVD) was evaluated using optical coherence tomography. We measured the level of depression, perceived stress, state, and trait anxiety and the degree of floater-associated discomfort with self-administered questionnaire. We compared psychological parameters between floater patients and control. We also compared clinical and psychological characteristics among different floater-associated discomfort severity groups.
RESULTS
Symptomatic vitreous floater patients showed higher rate of complete PVD and higher psychological distress compared to the control. On multiple logistic regression analysis, complete PVD ( = 0.001), depression ( = 0.001), and younger age ( = 0.037) were significantly associated with symptomatic floaters. There were no significant differences in complete PVD rate among different discomfort groups, while severe discomfort group showed higher depression, perceived stress, and state and trait anxiety compared to the other two milder symptom groups.
CONCLUSIONS
Symptomatic vitreous floater patients showed substantial level of psychological distress, and the severity of floater symptoms was significantly associated with psychological distress.
PubMed: 29375909
DOI: 10.1155/2017/3191576 -
International Journal of Ophthalmology 2013To estimate the prevalence and risk factors for vitreous floaters in the general population.
AIM
To estimate the prevalence and risk factors for vitreous floaters in the general population.
METHODS
An electronic survey was administered through a smartphone app asking various demographic and health questions, including whether users experience floaters in their field of vision. Multivariate logistic regression analysis was used to determine risk factors.
RESULTS
A total of 603 individuals completed the survey, with 76% reporting that they see floaters, and 33% reporting that floaters caused noticeable impairment in vision. Myopes were 3.5 times more likely (P=0.0004), and hyperopes 4.4 times more likely (P=0.0069) to report moderate to severe floaters compared to those with normal vision. Floater prevalence was not significantly affected by respondent age, race, gender, and eye color.
CONCLUSION
Vitreous floaters were found to be a very common phenomenon in this non-clinical general population sample, and more likely to be impairing in myopes and hyperopes.
PubMed: 23826541
DOI: 10.3980/j.issn.2222-3959.2013.03.27 -
Ophthalmology and Therapy Feb 2022To evaluate and compare the efficacy and safety of YAG laser vitreolysis in treating symptomatic vitreous floaters of complete posterior vitreous detachment (PVD) and...
INTRODUCTION
To evaluate and compare the efficacy and safety of YAG laser vitreolysis in treating symptomatic vitreous floaters of complete posterior vitreous detachment (PVD) and non-PVD.
METHODS
In this prospective cohort study, 51 eyes with symptomatic floaters were treated with YAG laser vitreolysis. Participants were divided into complete PVD and non-PVD groups. Objective visual quality measures including the Strehl ratio (SR), internal spherical aberration (SA), internal comatic aberration (CA), internal high-order aberration (HOA), area ratio of modulation transfer function (MTFa) and Vitreous Floaters Symptom Questionnaire (VFSQ-13) scores were used to compare the efficacy of YAG laser vitreolysis treatment between two groups.
RESULTS
The mean age of all patients was 56.80 ± 10.82 years old. In total, 36 of 51 (70.59%; 95% CI 58.10-83.10) patients reported their symptoms as significant or complete improvement after YAG laser vitreolysis treatment. Post-treatment MTFa, internal SA and internal HOA were significantly better compared to baseline (26.19 ± 14.73 vs. 29.19 ± 17.98, p = 0.013; 0.05 ± 0.05 vs. 0.04 ± 0.04, p = 0.031 and 0.23 ± 0.22 vs. 0.16 ± 0.07, p = 0.044; respectively) in all eyes. Twenty-nine of 51 (56.86%) eyes had floaters of non-PVD type. Significant or complete subjective improvements in the PVD group and non-PVD group were 72.73% and 68.97% (p = 0.344), respectively.
CONCLUSIONS
Improved subjective and objective visual quality in participants with symptomatic floaters following YAG laser vitreolysis was found in both groups. The efficacy of YAG laser vitreolysis was comparable in floaters of complete PVD and non-PVD types.
PubMed: 34778916
DOI: 10.1007/s40123-021-00422-6