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Jacey Hongjie Ma, Hui Huang, Rulong Gao, Shibo Tang; Ultra-widefield (UWF) Imaging Evaluated the Efficacy of YAG Laser Treatment for Symptomatic Vitreous Floaters. Invest. Ophthalmol. Vis. Sci. 2019;60(9):1554.
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© ARVO (1962-2015); The Authors (2016-present)
Symptomatic posterior vitreous detachment (PVD) is a common and impair visual quality. YAG laser provides alter treatment for the vitreous floaters other than observation or pass plana vitrectomy (PPV). We objectively evaluated the structural effects of YAG laser vitreolysis of floater using ultrawide field imaging, and examined subjective visual quality.
One hundred and thirteen eyes (91 patients; age ranged from 30 to 68) with symptomatic PVD treated by Ultra Q YAG laser vitreolysis in Guangzhou and Shenzhen Aier eye hospital from May 2015 to December 2017. Visual acuity (VA, Snellen decimal), intraocular pressure, visual quality questionnaire survey (0% to 100% change of visual disturbance were record as 10-point visual disturbance score, and a simplified Chinese version of NEI visual function questionnaire-25) were performed in all patients before and post-procedure. UWF image (Optos, Daytona) were used to recorded the morphology of vitreous opacity and retinal status before, intermediate after the treatment and at the last visit. A measurement software developed inhouse was applied to measure the size of the vitreous opacity. The measurements were normalized by the optic disc on the same image.
After treatments, ultrawide field image showed vitreous opacity was partially or completely (rang from 83% to 100%) removed. Vitreous opacity in 97 eyes were most completely removed. The results of the questionnaire survey showed that all patients replied subjectively trimmed or vanished vitreous opacity. However, 4 cases reported vanished plaque floater with multiple tiny dotted floaters were seen under the sun shine, which were not detectible with UWF image. 2 patients (2 eyes) were hit retina, and all outside the vascular arch, with no visual acuity effected. There were no complications such as increase in intraocular pressure or decreased vision during follow-up.
YAG laser treatment for symptomatic PVD was a safe and effective non-surgical alteration. Using UWF image is good to visualized the vitreous opacity around the optic disc resulted from PVD and is quantizable. However, the limitation of UWF image is which cannot visualize the tiny and semitransparent vitreous opacity.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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