Abstract
Purpose :
Introduce VFO and SK-VFO Test: new more representative terminology for symptoms of vitreous floaters/opacities (VFO) and new standardized kinetic (SK) anatomical-functional assessment.
Methods :
Retrospective interventional data collection of eight eyes (five patients) who visited The Retina Clinic London (London, UK) between May 2021 and September 2022. All patients suffered from bothersome VFO for a minimum of three months and underwent before and after limited vitrectomy surgery (LV) the following SK VFO Test: best-corrected visual acuity (BC-VA), low-luminance (LL-VA), MNREAD® near VA, contrast sensitivity function (CV1000E) (CSF), straylight measurements (SM) (HDA/ LDA/C-Quant). SK infra-red confocal SLO (SK IRcSLO) and swept-source widefield OCT (SS-WF-OCT) were used to identified VFO and posterior vitreous detachment (PVD) status. SK IRcSLO was performed with gaze directed towards the extreme superior, inferior, and lateral directions letting us see the kinetic characteristics of VFO. On average, the testing lasted 2.5 hours.
Results :
Eight eyes of five consecutive subjects (three males, two females) were assessed. Median patient age was 60 years (range 53 to 73), and all patients were myopic. Posterior vitreous detachment was preoperatively diagnosed in six eyes (75%). All SK-VFO Test results were statistically insignificant due to the small sample size. However, we noticed clear trends of improvement in some measurements. Anatomical-functional results after LV improved in seven eyes (87.5%): Objective Scatter Index (OSI) (27.34%), Disturbance Index (47.97%) and C-Quant Log units (2.26%). Pre-LV SK IRcSLO and SS-WF-OCT imaging identified dynamic well-defined VFO and PVD status (100%). A residual asymptomatic anterior cortical vitreous-induced shadowing ripple effect was detected post-LV.
Conclusions :
First objective and standardised test that provides additional insight into the type of VFO and severity of symptoms, taking into account the anatomic and kinetic characteristics of VFO: number, dimensions, opacity, movement, and latency. The SK VFO Test has the potential to personalise treatment of VFO and define eligibility criteria for either full or limited vitrectomy, with or without phacoemulsification, or Nd-YAG laser vitreolysis.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.