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Christiane Falkner-Radler, Minhee Cho, Alexandra Garf, Anton Orlin, R.V. Paul Chan, Szilard Kiss, Donald D’Amico, Susanne Binder; Symptomatic Posterior Vitreous Detachment: The predictive value of the posterior hyaloid face and symptomatology. Invest. Ophthalmol. Vis. Sci. 2013;54(15):2842.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate relationships between acute onset posterior vitreous detachment (PVD) symptoms, stages of PVD, and retinal complications in a prospective bicenter trial.
Patients presenting with acute onset of PVD symptoms like “floaters” (group1), “flashes of light” (group 2), or “floaters and flashes of light” (group 3), who were examined at one of the two study centers [Rudolf Foundation Clinic, Vienna (center 1) and the Weill Cornell Medical College, New York City (center2)] were included in the study. The condition of the posterior hyaloid face was assessed using spectral-domain optical coherence tomography (SD-OCT). Co-factors analyzed included best-corrected distance and near visual acuity (BCVA), sex, age, status of the lens (phakic, pseudophakic), refractive status (emmetropic, hyperopic, myopic), previous cataract and refractive surgery, the presence of vitreous pigment, vitreous hemorrhage, lattice degeneration, retinal tears and/or retinal detachment, positive family or personal history, one or both eyes affected. Correlations between the 3 clinical symptom groups, stages of PVD and the occurrence of retinal complications and the other co-factors were evaluated using a regression model.
Up to now, 106 patients (56 patients in group 1, 22 patients in group 2 and 28 patients in group 3) have been included. Eighteen % of patients showed no PVD, 43% to 57% of patients an incomplete foveal and/or optic PVD, and 25% to 39% of patients a complete PVD. Therese findings were not significantly different (p<0.56) between the 3 groups. A significant difference between the groups were found for the presence of vitreous syneresis (70% in group 1, 86% in group 2 and 93% in group 3; p<0.03). In addition, the occurrence of lattice degeneration was significantly different between the groups (4% in group 1, 27% in group 2 and 14% in group 3; p<0.01). No significant differences were found for retinal tears (p=0.05) and the other co-factors. However, retinal tears occurred more often in group 3.
In the majority of patients with acute onset PVD symptoms the posterior hyaloid face is incompletely or fully detached. However, in this preliminary series it was not possible to identify patients at risk for developing retinal complications.
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