Abstract
Purpose :
Posterior hyaloid discontinuity is a novel swept-source optical coherence tomography (SS-OCT) finding defined as an apparent break in the posterior hyaloid, with the potential for liquified vitreous to prolapse through this discontinuity. In this retrospective case series, we investigated patients with first presentation posterior vitreous detachment (PVD) or vitreomacular traction (VMT) to characterize features of posterior hyaloid discontinuity.
Methods :
We analyzed all patients with available SS-OCT images between February 26, 2019 to September 30, 2022. Eyes with retinal detachment, proliferative diabetic retinopathy, neovascular age-related macular degeneration, vitreous hemorrhage, or other visually significant ocular conditions were excluded. The posterior vitreous was assessed for signs of separation of the posterior hyaloid from the macula or peripapillary area, characterizing a partial PVD, or any tractional abnormalities such as VMT or macular hole (MH). Brightness and contrast were individually adjusted during vitreous imaging to enhance visualization. If present, the size and location of the posterior hyaloid discontinuity was recorded.
Results :
128 eyes from 99 patients were included. The median age was 63-years old (IQR 56-68). The mean best corrected visual acuity (BCVA) on the date of SS-OCT imaging was 0.24 (SD 0.31) logMAR (20/35 Snellen). The median follow-up from initial SS-OCT was 11.7 months (IQR 0-19.4). The incidence of VMT, partial-thickness MH (PTMH), and full-thickness MH (FTMH) was 12.5% (n=16), 2.3% (n=3), and 9.4% (n=12) respectively. A total of 34.4% had a posterior hyaloid discontinuity on OCT (n=43). Of these, the average linear diameter of discontinuity was 1302 μm (SD 1458 μm). The most common location of discontinuity was peripheral (32%, n=15), followed by perifoveal or parafoveal (27%, n=13), foveal (23%, n=11), and peripapillary (16%, n=8). 8 eyes demonstrated formed vitreous prolapse through these discontinuities.
Conclusions :
Posterior hyaloid discontinuity is a novel SS-OCT finding which is common amongst patients with first presentation PVD. Further studies with larger sample sizes and longitudinal follow-up are required to elicit any associations or predictive ability of this finding on progression or formation of PVD to tractional abnormalities or retinal detachments.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.