Spotlight on Asteroid Hyalosis: A Clinical Perspective

Abstract

Asteroid hyalosis is a benign degenerative condition of the vitreous that is often asymptomatic. Our purpose with this narrative review is to provide a current overview of asteroid hyalosis from a clinical perspective. We review the epidemiology and risk factors, the clinical diagnosis and differential diagnoses, clinical challenges in eyes with asteroid hyalosis, and the treatment of asteroid hyalosis. Many clinical questions remain unanswered, and the current evidence to guide clinical practice is largely based on anecdotal evidence and clinical experience. More studies on asteroid hyalosis from a clinical perspective are warranted.

Asteroid Hyalosis: A Mimicker of Vitreous Hemorrhage on Point of Care Ultrasound: A Case Report

“…Increasing age and male sex are the most significant risk factors for asteroid hyalosis 4 . Systemic comorbidities, such as diabetes, hyperlipidemia, and hypertension, have been reported to be associated with asteroid hyalosis 8 ; however, when adjusted for age and sex, this association appears to lack significance 9 .…”

“…Asteroid hyalosis is rarely symptomatic unless severe or if concurrent ocular pathology, including cataracts, vitreous hemorrhage, or diabetic retinopathy, is present. While often an incidental finding, asteroid hyalosis can confound retinal or fundoscopic imaging due to its numerous vitreous opacities 3 , 8 . While often detected by a comprehensive ophthalmologic examination, asteroid hyalosis can also be detected with POCUS, a readily available diagnostic tool for emergency physicians.…”

Galactic vision: asteroid hyalosis in vitreous with moonlit optic disc

“…Widespread floaters, glare and visual obscurations are indications for surgery in symptomatic patients. It is also indicated when asteroid bodies impede fundus visualisation, making it difficult to assess posterior segment pathology adequately, or when improved visualisation is necessary for focal laser or pan-retinal photocoagulation treatment 9…”

Role of the Vitreous in Retinal Pathology: A Narrative Review

“…AH is a relatively common cause of vitreous opacities, possibly associated with diabetes mellitus (DM) and hereditary pigmentary retinopathies [ 4 ]. Although some individuals experience visual discomfort or blurring, especially if the opacities are densely crowded close to the macula, AH is generally asymptomatic in most patients [ 5 ]. The etiology of AH remains to be elucidated.…”