Evolution of Vitreomacular Detachment in Healthy Subjects

Itakura, Hirotaka; Kishi, Shoji

doi:10.1001/jamaophthalmol.2013.4578

Cited by 69 publications

(63 citation statements)

References 22 publications

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“…Uchino et al [17] evaluated the initial stages of PVD by OCT in a large prospective study of healthy eyes and demonstrated that the early stages of PVD are chronic and slowly progressive. Further evidence for the chronicity of PVD stages has been reported by several studies [19,20,21]. …”

Section: Discussionsupporting

confidence: 60%

Long-Term Observation of the Vitreomacular Relationship in Normal Fellow Eyes of Patients with Unilateral Idiopathic Macular Holes

Otsuji

Uemura²,

Nakano³

et al. 2014

Ophthalmologica

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Purpose: To describe long-term changes in the vitreomacular relationship in normal fellow eyes of patients with unilateral idiopathic macular holes (MHs). Methods: This is a retrospective, observational case series. The medical records of patients who underwent surgery for idiopathic MHs between May 2000 and December 2010 were reviewed. Patients who had clinically normal fellow eyes and underwent 12 months or more of follow-up were included. The vitreomacular relationship in the fellow eyes was evaluated using optical coherence tomography (OCT) and slit-lamp biomicroscopy. Results: The study included 153 patients with a mean age of 65.5 years and a mean follow-up of 33.5 months (range, 12-121). The incidence of vitreomacular attachments evaluated by OCT was 52% (80 eyes) at initial examination, which decreased to 41, 37 and 23% at 1, 2 and 3 years after the initial examination, respectively. Of the 80 eyes with vitreomacular attachments at initial examination, 40 (50%) still had vitreomacular attachments at the final visit. Of the remaining 40 eyes in which vitreomacular separation occurred during follow-up, 11 (28%) developed an MH, with a mean interval of 45 months. None of the eyes with vitreomacular separation at presentation developed an MH. Conclusion: This largest series of fellow eyes of MHs followed by OCT shows that, at presentation, about half of the patients already have premacular vitreous detachment and therefore no risk of MH, and that second MH develops in about 30% in the process of vitreomacular separation, which evolves over a prolonged period.

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Section: Discussionsupporting

confidence: 60%

Long-Term Observation of the Vitreomacular Relationship in Normal Fellow Eyes of Patients with Unilateral Idiopathic Macular Holes

Otsuji

Uemura²,

Nakano³

et al. 2014

Ophthalmologica

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“…This analysis was done based on the fact that the retinal structures are highly symmetrical at upper and lower hemispheres in normal eyes [3, 37]. The condition of a PVD was determined and classified, as was done in a previous report [38], with vertical and horizontal Spectralis OCT scans through the fovea in eyes with microcystic lesions.…”

Section: Methodsmentioning

confidence: 99%

Microcystic Inner Nuclear Layer Changes and Retinal Nerve Fiber Layer Defects in Eyes with Glaucoma

et al. 2015

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ObjectiveTo examine microcystic inner nuclear layer (INL) changes in glaucomatous eyes and to determine associated factors. DesignRetrospective, cross-sectional, observational study. MethodsTwo hundred seventeen eyes of 133 patients with primary open angle glaucoma (POAG), 41 eyes of 32 patients with preperimetric glaucoma and 181 normal eyes of 117 subjects were ultimately included. Microcystic INL lesions were examined with infrared fundus images and with 19 vertical spectral domain optical coherence tomography (SD-OCT) images in the macular area.ResultsMicrocystic INL changes were observed in 6.0% of eyes with POAG, but none of the normal eyes or eyes with preperimetric glaucoma showed microcystic INL changes. The proportion of eyes with advanced glaucoma was significantly larger (P = 0.013) in eyes with microcystic lesions than without. The visual field mean deviation (MD) slope was also significantly worse (P = 0.027) in eyes with microcystic lesions. No significant differences were observed in age, sex, refraction, axial length, intraocular pressure, or MD value between eyes with and without microcystic INL lesions. In several cases, microcystic INL lesions occurred along with glaucomatous visual field progression. The retinal nerve fiber layer (RNFL) thickness (P = 0.013) and ganglion cell layer (GCL) + inner plexiform layer thickness (P = 0.023) were significantly lower in areas with microcystic lesions than without. The INL was also significantly thicker (P = 0.002) in areas with microcystic lesions.ConclusionsMicrocystic INL lesions in glaucomatous eyes are closely associated with RNFL and GCL thinning and correlated with worse MD slope. These INL lesions may indicate focal and progressive damage in glaucoma.

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“…2 Also, the presence of PPVP was suspected to be associated with macular hole formation 3,4 and the feature of the PPVP was postulated to be involved in the development of a perifoveal posterior vitreous detachment (PVD). 5 Some investigators suggested the possible role of PPVP in the movement of intrinsic and extrinsic mediators between the anterior and the posterior segment. 6 Although in vivo visualization of PPVP was attempted using triamcinolone acetonide 7,8 and B-scan ultrasonography, 4 the detailed profile of PPVP has been revealed after the advent of optical coherence tomography (OCT).…”

Section: Introductionmentioning

confidence: 99%