Abstract

Vitreous plays an important role in ocular physiology and the maintenance of media transparency. Aging and various systemic diseases induce molecular and structural changes resulting in posterior vitreous detachment (PVD). Anomalous PVD occurs when gel liquefaction is not matched by vitreoretinal dehiscence. Consequences include retinal tears and detachment, vitreo-papillary traction, vitreo-macular traction, as well as macular holes and macular pucker involving vitreoschisis. Vitreo-macular adhesion exacerbates age-related macular degeneration and macular edema in diabetes and other retino-vascular disorders. Vitrectomy surgery, at times with vitreoretinal interface chromodissection, is performed to alleviate these conditions but will increasingly be replaced by pharmacologic vitreolysis to treat as well as prevent anomalous PVD.

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