Purchase this article with an account.
Stephen Laswell, Charles Clifton Wykoff, David M Brown; Posterior Vitreous Detachment Assessment by Age Using Circumpapillary Optical Coherence Tomography. Invest. Ophthalmol. Vis. Sci. 2021;62(8):2461.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Consideration of posterior vitreous detachment (PVD) status is highly clinically relevant for managing a host of vitreoretinal disorders and in planning for vitreoretinal surgery. However, the translucent nature of vitreous humor makes definitive clinical assessment of PVD challenging. The goal of this study was to define patterns of posterior vitreous cortex (PVC) changes using circumpapillary spectral-domain optical coherence tomography (SD-OCT).
The vitreoretinal interface of 1685 eyes of 879 clinical retina patients were retrospectively analyzed using 100 ART HS circumpapillary OCT and 6mm2 macular OCT (Heidelberg OCT2) by 3 masked graders. The primary outcome was the vitreoretinal interface status, graded using a modified staging system (initially described by Uchino et al, 2001); 0) no PVD: tight vitreoretinal adhesion with no discernible separation 1) insignificant separation: partial vitreoretinal separation, with no separation of the PVC within the papillo-macular bundle 2) Clinically relevant separation: separation of the PVC within the papillo-macular bundle with persistent vitreofoveal attachment 3) vitreofoveal separation with persistent vitreoretinal adhesion at the optic disc 4) Full PVD: Dark absence of signal anterior to the retina or with pinpoint translucence consistent with vitreous cells or hemorrhage.
Complete separation between the circumpapilary retina and PVC was detected by circumpapillary OCT in 706 of 1678 eyes (41.90%). Of 1685 scans analyzed in this study, 4 (0.24%) were deemed to have an indeterminate PVD status. By age, PVD was detected in 0/42 eyes age 1-18 (P<<0.001), 2/72 eyes (2.78%) age 19-29 (P<<0.001), 11/127 eyes (8.66%) age 30-39 (P<<0.001), 17/203 eyes (8.37%) age 40-49 (P<<0.001), 106/307 eyes (34.53%) age 50-59 (P < 0.05), 229/461 eyes (49.67%) age 60-69 (P<0.01), 211/324 eyes (65.12%) age 70-79 (P<<0.001), 110/128 eyes (85.94%) age 80-89 (P<<0.001), and 20/21 eyes (95.24%) age 90+ (P<<0.001).
Analysis of the PVC with routine circumpapillary OCT scans is shown to be an effective, readily available means of evaluating PVD status; circumpapillary OCT may be valuable in discerning the vitreoretinal interface status for cases in which it may be clinically ambiguous. Results corroborate well-established progression of PVD with age while showing evidence that PVD initiates at earlier ages than previously reported.
This is a 2021 ARVO Annual Meeting abstract.
This PDF is available to Subscribers Only