TY - JOUR
T1 - Posterior Vitreous Detachment as Observed by Wide-Angle OCT Imaging
AU - Tsukahara, Mayuka
AU - Mori, Keiko
AU - Gehlbach, Peter L.
AU - Mori, Keisuke
N1 - Funding Information:
This is an observational cross-sectional study. A total of 144 eyes of 98 healthy normal volunteers underwent a wide-angle montage of OCT images of their entire viewable vitreoretinal interface. The investigation adhered to all of the tenets of the Declaration of Helsinki. This study was approved by the institutional review board of the Saitama Medical University (approval no. 11-041-01) and the Ethics Committee of International University of Health and Welfare (approval no. 13-B-225). Subjects were enrolled from August 2011 to December 2012 in the Saitama Medical University and from October 2016 to April 2017 in the International University of Health and Welfare. The composition of the subject population was 60 female and 38 male participants, ranging in age from 21 to 95 years (51.4±22.0, mean ± standard deviation) ( ). All subjects were examined by indirect ophthalmoscopy, slit-lamp biomicroscopic examination, refraction, and best-corrected visual acuity testing. Excluded were eyes with present or past vitreous-retina-choroid disease, hyperopia >+3.0 diopters or myopia exceeding −5.0 diopters, and advanced cataract that may affect the image quality. Table 1
Publisher Copyright:
© 2018 American Academy of Ophthalmology
PY - 2018/9
Y1 - 2018/9
N2 - Purpose: Posterior vitreous detachment (PVD) plays an important role in vitreoretinal interface disorders. Historically, observations of PVD using OCT have been limited to the macular region. The purpose of this study is to image the wide-angle vitreoretinal interface after PVD in normal subjects using montaged OCT images. Design: An observational cross-sectional study. Participants: A total of 144 healthy eyes of 98 normal subjects aged 21 to 95 years (51.4±22.0 [mean ± standard deviation]). Methods: Montaged images of horizontal and vertical OCT scans through the fovea were obtained in each subject. Main Outcome Measures: Montaged OCT images. Results: By using wide-angle OCT, we imaged the vitreoretinal interface from the macula to the periphery. PVD was classified into 5 stages: stage 0, no PVD (2 eyes, both aged 21 years); stage 1, peripheral PVD limited to paramacular to peripheral zones (88 eyes, mean age 38.9±16.2 years, mean ± standard deviation); stage 2, perifoveal PVD extending to the periphery (12 eyes, mean age 67.9±8.4 years); stage 3, peripapillary PVD with persistent vitreopapillary adhesion alone (7 eyes, mean age 70.9±11.9 years); stage 4, complete PVD (35 eyes, mean age 75.1±10.1 years). All stage 1 PVDs (100%) were observed in the paramacular to peripheral region where the vitreous gel adheres directly to the cortical vitreous and retinal surface. After progression to stage 2 PVD, the area of PVD extends posteriorly to the perifovea and anteriorly to the periphery. Vitreoschisis was observed in 41.2% at PVD initiation (stage 1a). Conclusions: Whereas prior work suggests that PVD originates in the perifoveal region and after the sixth decade, our observations demonstrate that (1) PVD first appears even in the third decade of life and gradually appears more extensively throughout life; (2) more than 40% of eyes without fundus diseases at their PVD initiation are associated with vitreoschisis; and (3) PVD is first noted primarily in the paramacular-peripheral region where vitreous gel adheres to the retinal surface and is noted to be more extensive in older ages to ultimately involve the fovea.
AB - Purpose: Posterior vitreous detachment (PVD) plays an important role in vitreoretinal interface disorders. Historically, observations of PVD using OCT have been limited to the macular region. The purpose of this study is to image the wide-angle vitreoretinal interface after PVD in normal subjects using montaged OCT images. Design: An observational cross-sectional study. Participants: A total of 144 healthy eyes of 98 normal subjects aged 21 to 95 years (51.4±22.0 [mean ± standard deviation]). Methods: Montaged images of horizontal and vertical OCT scans through the fovea were obtained in each subject. Main Outcome Measures: Montaged OCT images. Results: By using wide-angle OCT, we imaged the vitreoretinal interface from the macula to the periphery. PVD was classified into 5 stages: stage 0, no PVD (2 eyes, both aged 21 years); stage 1, peripheral PVD limited to paramacular to peripheral zones (88 eyes, mean age 38.9±16.2 years, mean ± standard deviation); stage 2, perifoveal PVD extending to the periphery (12 eyes, mean age 67.9±8.4 years); stage 3, peripapillary PVD with persistent vitreopapillary adhesion alone (7 eyes, mean age 70.9±11.9 years); stage 4, complete PVD (35 eyes, mean age 75.1±10.1 years). All stage 1 PVDs (100%) were observed in the paramacular to peripheral region where the vitreous gel adheres directly to the cortical vitreous and retinal surface. After progression to stage 2 PVD, the area of PVD extends posteriorly to the perifovea and anteriorly to the periphery. Vitreoschisis was observed in 41.2% at PVD initiation (stage 1a). Conclusions: Whereas prior work suggests that PVD originates in the perifoveal region and after the sixth decade, our observations demonstrate that (1) PVD first appears even in the third decade of life and gradually appears more extensively throughout life; (2) more than 40% of eyes without fundus diseases at their PVD initiation are associated with vitreoschisis; and (3) PVD is first noted primarily in the paramacular-peripheral region where vitreous gel adheres to the retinal surface and is noted to be more extensive in older ages to ultimately involve the fovea.
UR - http://www.scopus.com/inward/record.url?scp=85045021828&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85045021828&partnerID=8YFLogxK
U2 - 10.1016/j.ophtha.2018.02.039
DO - 10.1016/j.ophtha.2018.02.039
M3 - Article
C2 - 29631900
AN - SCOPUS:85045021828
SN - 0161-6420
VL - 125
SP - 1372
EP - 1383
JO - Ophthalmology
JF - Ophthalmology
IS - 9
ER -