Current treatment strategies for symptomatic vitreous opacities

Abstract

Purpose of reviewSymptomatic 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 findingsDespite 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. SummaryVitrectomy 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.

Vitreous Opacity Vitrectomy (VOV): Safest Possible Removal of “Floaters”

“… 1 , 28–30 These serve an ancillary documentation purpose, but only a patient’s substantial symptoms (correlated with vitreous physical examination) are sufficient, indispensable, and treatment actionable. 31 For example, while cautioning regarding vitrectomy risks, Henry et al posed the rhetorical question “Is a reduction in contrast sensitivity enough of an indication to support vitrectomy, when a patient has excellent visual acuity?” 32 But after having read statements by DVS sufferers, one would quickly understand that their problems go well beyond either a contrast sensitivity or visual acuity number.…”

Ten Years of Knowledge of Nano-Carrier Based Drug Delivery Systems in Ophthalmology: Current Evidence, Challenges, and Future Prospective

“…The main complaint of vitreous opacity is the visual phenomenon of “floating view”. 135 As nanomedicine-based therapeutic solution can locally ablate “floaters” and highly reduce light energy, compared with traditional YAG laser therapy. Sauvage et al proposed hyaluronic acid (HA)-coated gold nanoparticles to localize them with greatly reduced light energy.…”

Application and visualization study of an intelligence-assisted classification model for common eye diseases using B-mode ultrasound images

“…Leveraging ultrasound technology, it produces real-time images of internal eye structures and holds extensive clinical utility. Diseases such as vitreous opacities, posterior vitreous detachment (PVD), retinal detachment, and choroidal detachment represent common eye ailments ( Bellows et al, 1981 ; Ghazi and Green, 2002 ; Shinar et al, 2011 ; Gishti et al, 2019 ; Ryan, 2021 ), often discernible through eye B-mode ultrasound images.…”