Abstract
Purpose :
Asteroid hyalosis (AH) is a degenerative vitreous disease that can cause acute decreased vision in the setting of a progressive posterior vitreous detachment (PVD), which is reversible with pars plana vitrectomy (PPV).
Methods :
Retrospective chart review of 3 eyes in 3 patients with acute decreased visual acuity (VA) in the setting of asteroid hyalosis with a clinically documented separation of the posterior hyaloid who were treated at Associated Retinal Consultants, P.C.
Results :
The median age of the 1 male and 2 female patients was 78 years (range 74-83), and all were pseudophakic in the affected eye. The VA prior to PVD ranged from 20/25 to 20/200 (logMAR 0.1-1.0). All 3 patients reported a decline in vision with a new PVD diagnosed clinically in 2 eyes and a progressing separation of the posterior hyaloid in 1 eye. The average decline in vision after anterior progression of the posterior hyaloid position was 4 Snellen lines (logMAR 0.70). There were no other contributing factors to acute vision loss in these cases. At the time of PPV, a complete PVD was confirmed in 1 eyes; the other 2 eyes showed partial elevation of the hyaloid with vitreous cortex remaining on the posterior retina. Following surgical clearance of the asteroid bodies, VA returned to baseline within 1 month for 2 eyes, and within 3 months for all eyes.
Conclusions :
Although AH is typically associated with minimal subjective complaints, posterior vitreous separation appears to concentrate asteroid bodies into the anterior vitreous, thereby increasing their density and causing a marked visual impairment. Our case series demonstrates that PPV is effective at reversing vision loss caused by progressive posterior vitreous separation in eyes with AH, including cases with vitreoschisis.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.