Abstract

Vitreous “floaters” are a common entoptic phenomenon that can result in significant reduction in quality of life in a proportion of sufferers. The authors use a computational mathematical model based on Fourier optics and reflection and transmission coefficients calculated for a planar type II collagen opacity suspended in aqueous to show that floaters are perceived by the patient through interference effects that result in significant variations in intensity on the retina when viewing a constant brightness surface. The model also predicts that backscattered intensity from floaters is ten thousand to one million times lower than the variations in intensity produced on the retina, which demonstrates that the visible effects of floaters for the patient can be highly significant, whereas clinical observation of the vitreous may be entirely unremarkable. Importantly, the results also demonstrate that floaters do not need to be opaque to cause symptoms, with only small differences in refractive index between the floater material and the surrounding vitreous needed to produce significant optical effects. The model predicts that pupil size is an important factor in determining the severity of symptoms from floaters, with constricted pupils giving much greater effect than dilated pupils. Finally, the authors’ model predicts that floaters degrade contrast sensitivity function, with greatest degradation occurring in the 5–40 cycles per degree spatial frequency range and that the effects of shadowing caused by floaters are very strongly correlated to the predicted degradation of contrast sensitivity function. Bioelectromagnetics. 43:90–105, 2022. © 2021 The Authors. Bioelectromagnetics published by Wiley Periodicals LLC on behalf of Bioelectromagnetics Society.

Highlights

  • Vitreous floaters are a common entoptic phenomenon that can have a considerable detrimental effect on the quality of life in a small but significant proportion of those that are symptomatic [Sebag, 2011; Wagle et al, 2011; Zou et al, 2013; Luff and O'Donnell, 2018]

  • Modelling using the MATLAB code developed by the authors allows the computation of point spread function (PSF), the spatial frequency domain analogue, modulation transfer function (MTF) at the retina, and the contrast sensitivity function (CSF) for the whole human visual system to be estimated

  • What is less obvious is that the frequency dependence of this degradation should be greater in the high spatial frequency range, and symptoms of shadowing caused by vitreous opacity should correlate strongly only to degradation in high frequency CSF

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Summary

INTRODUCTION

Vitreous floaters are a common entoptic phenomenon that can have a considerable detrimental effect on the quality of life in a small but significant proportion of those that are symptomatic [Sebag, 2011; Wagle et al, 2011; Zou et al, 2013; Luff and O'Donnell, 2018]. The authors' aims are to prove, theoretically, that vitreous opacity can result in variations in the intensity distribution on the retina, and be perceived by the patient with SVO; to show that backscattering from vitreous opacity is very much smaller than forward scattering and explain the difficulty in matching subjective symptoms with objective examination; and to explain the link between degradation in contrast sensitivity function with the presence of SVO In providing this solid scientific explanation, based on physics, the authors hope to provide explanation and additional reassurance to clinicians considering surgical intervention for SVO in an eye with unremarkable clinical examination

MATHEMATICAL MODEL
Equation iz
SIMULATION RESULTS
Spatial frequency range pupil diameter mm
CONCLUSIONS
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