Acute Symptomatic Posterior Vitreous Detachment Research Articles

Окт диагностика скрытого клапанного разрыва при задней отслойке стекловидного тела

Changes in the posterior vitreous that look like hyperreflective dots are considered as a predictor of peripheral retinal breaks in acute posterior vitreous detachment (PVD), along with Shafer's sign, intraretinal and vitreous hemorrhages. Some of peripheral breaks in acute PVD remain unnoticed at the initial ophthalmoscopic examination due to poor visualization. We report a clinical case of an invisible peripheral retinal flap tear detection with overview wide-field OCT (RTVue XR Avanti, Line mode –12 mm) scanning by «sliding» method in the area of retinal hemorrhage in presence of multiple hyperreflective dots in the vitreous during acute symptomatic PVD. Key words: acute PVD; invisible flap tear; wide-field OCT; retinal hemorrhage; stardust sign; hyperreflective dots.

Acute symptomatic vitreous floaters assessed with ultra-wide field scanning laser ophthalmoscopy and spectral domain optical coherence tomography

To describe the eyes with vitreous floaters and to analyze the development of acute symptomatic posterior vitreous detachment (PVD). A retrospective review of medical records was performed on patients with the vitreous floater developed for the first time of their life. Peripapillary vitreous opacity (pVO) was searched in Ultra-wide field (UWF) scanning laser ophthalmoscopy and PVD stage was assessed through spectral-domain optical coherence tomography (SD-OCT). 196 patients (55 males and 141 females), who were 58.4 (± 9.1) years old, visited a retinal clinic 9.4 (± 9.1) days after they experienced vitreous floaters. In 196 eyes, pVO was noticed in 122 eyes (62.2%) at UWF. In 106 eyes where SD-OCT data were available, PVD was noticed in 100 eyes (94.3%). Symptomatic eyes showed more advanced stage of PVD (p < 0.001) than symptom free eyes. Eyes with floaters were more myopic (− 0.7 ± 2.2D vs − 0.5 ± 1.9D, p = 0.02), and had lower intraocular pressure (IOP) (14.7 ± 3.2 mmHg vs 15.2 ± 3.0 mmHg, p = 0.02) than the other symptom free eyes. In patients with first floater symptoms, PVD was in progress in most of the eyes not only the symptomatic eyes but also on the contralateral symptom free eyes. Eyes with vitreous floaters were more myopic and had lower IOP than the opposite symptom free eyes.

Posterior vitreous detachment-study of prevalence, symptoms and risk factors for retinal tears

Purpose: To describe clinical characteristics of patients who presented with acute symptomatic posterior vitreous detachment (PVD) and determine the prevalence and predictors of retinal tears and retinal complications.Material and methods: 250 patients who presented in RIO, PGIMS, Rohtak, Haryana with clinical diagnosis of acute symptomatic PVD were examined and followed up over a period of 1 year. Results: A total of 250 patients who presented with acute PVD-related symptoms like floaters, flashes of light or deterioration in vision were enrolled in our study. Incidence of retinal tear was found to be 8% (n=20) and that of vitreous hemorrhage or retinal hemorrhage was 14% (n=35) in our study group over a period of 1 year. Predictors of retinal tears were visual impairment, vitreous hemorrhage and duration of symptoms

Ultrasonic examination of the reliability of vitreous hemorrhage after acute symptomatic posterior vitreous detachment of retinal tear

Objective To evaluate the reliability of ultrasonic examination of vitreous hemorrhage after acute symptomatic posterior vitreous detachment of retinal tear. Methods The data of 80 eyes of 80 patients with acute symptomatic posterior vitreous detachment from Jan. 2015 to Dec. 2017 were analyzed retrospectively. Ultrasound examination and indirect ophthalmoscopy were performed on all patients. The results of the indirect ophthalmoscope examination were used as the gold standard to compare the results of the two tests. Results Membrane lesions characterized by retinal tear ultrasound were described in 13 patients (16.25%). Fundus indirect ophthalmoscopy examination confirmed the diagnosis of 8 patients and they recived laser photocoagulation.The local vitreous condensation was detected in other 5 cases.One case received laser photocoagulation due to secondary changes in retinal traction.Sensitivity was 100.00% (95% CI, 60.14%-100.00%), specificity was 93.06% (95% CI, 58.51%-97.82%), positive predictive value was 61.53% (95% CI, 32.82%-85.76%)and negative predictive value was 100.00% (95% CI, 93.09%-100.00%). The positive likelihood ratio was 13.41 (95% CI, 5.82-31.114) and the negative likelihood ratio was 0. Conclusion Ultrasonography has high sensitivity and negative predictive value in the detection of vitreous hemorrhage after acute symptomatic posterior vitreous detachment of the retina, and is used to exclude high reliability of retinal tear. Key words: Ultrasonography; Posterior, detachment, vitreous, symptomatic, acute; Tear, retinal; Hemorrhage, Vitreous

Comment on "Ultrasound reliability in detection of retinal tear in acute symptomatic posterior vitreous detachment with vitreous hemorrhage".

Comment on "Ultrasound reliability in detection of retinal tear in acute symptomatic posterior vitreous detachment with vitreous hemorrhage".

Incidence of Acute Symptomatic Posterior Vitreous Detachment, its Complications and Impact on Emergency Eye Care Set Up

Purpose. To determines the incidence of complications of acute symptomatic posterior vitreous detachment (PVD) and its impact on ophthalmic emergency setup. Design. A retrospective study of 172 patients presented in one years’ time, with acute symptomatic posterior vitreous detachment. Methods. A retrospective record of 172 patients (n=172) was reviewed who were seen in one years’ time period at local hospital’s eye departments as emergency referrals. Referrals were made by primary care physicians and optometrists. Only patients with acute symptomatic PVD were taken into account. Their symptomatology, visual acuity, fundus examination findings, follow up appointments and outcomes were checked. Results. Mean age at presentation was 62.76 years. Acute Symptomatic Posterior vitreous detachment was detected without complications in 126 (73.25%). Retinal breaks were found on initial presentation in 33 patients (19.18%). Out of these, 18 had rhegmatogenous retinal detachment on initial presentation (10.46%), while one patient who also had vitreous haemorrhage developed it later. PVD was seen with vitreous haemorrhage in 4 patients (2.32%). Seven patients presented with PVD and associated retinal haemorrhages (4.06%). Demographically 96 patients were females (55.81%) as compared to 76 males (44.186%). The highest incidence was between 51 to 75 years of age (84.29%). Posterior vitreous detachments accounted for 7.50% of total eye emergencies in one year. Conclusions. Patients with flashes and floaters should be seen urgently. Priority should be given to patients with cells in vitreous (shafer’s sign) as well as retinal or vitreous haemorrhages. These patients should be seen by experienced ophthalmologist to rule out any break with 360 degree indirect ophthalmoscopic examinations. Junior doctors should have extensive training with indirect ophthalmoscopy with scleral indentation and should not miss shafer’s sign in all patients with acute symptomatic PVD.

Ultrasound reliability in detection of retinal tear in acute symptomatic posterior vitreous detachment with vitreous hemorrhage.

Cross-sectional study of 75 consecutive patients presenting with acute symptomatic posterior vitreous detachment (ASPVD) and vitreous hemorrhage was conducted at University Eye Clinic, University Hospital "Sveti Duh", Zagreb, Croatia. To check ultrasound reliability in detecting retinal tears in patients with ASPVD, transpalpebral ultrasound of the eye and the orbit was performed followed by fundus examination initially and in 6wk period. In 13 (17%) patients membranous lesion with ultrasound characteristics of retinal tear was detected. Ophthalmoscopy confirmed the diagnosis in 8/13 patients. In 62/75 patients neither ultrasound nor clinical examination revealed retinal tear. Sensitivity of ultrasound examination was 100%, specificity 92%, positive predictive value 62% and negative predictive value 100%. Ultrasound proved to be a reliable and accurate method for detection of retinal tears in ASPVD. Given the high sensitivity and negative predictive value, negative result on B-scan ultrasound excludes the probability of the retinal tear with a high degree of certainty.

Vitreous Hyper-Reflective Dots in Optical Coherence Tomography and Retinal Tear in Patients with Acute Posterior Vitreous Detachment

ABSTRACTPurpose: To report the presence of hyper-reflective dots in the vitreous cavity using spectral-domain optical coherence tomography (SD-OCT) in patients with acute symptomatic posterior vitreous detachment (PVD) and investigate their association with the presence of retinal tear.Methods: The medical records of 77 patients with acute symptomatic PVD, who were examined between March 2013 and February 2015, were reviewed. The severity of vitreous hyper-reflective dots (VHDs) was graded using SD-OCT images, and the presence of retinal tear was assessed.Results: Forty-one (53.2%) eyes had mild VHDs, 13 (16.9%) eyes had moderate VHDs, and 14 (18.2%) eyes had severe VHDs. Retinal tear was found in 21 (27.3%) eyes. The presence of severe VHDs was associated with an increased likelihood of retinal tear (positive likelihood ratio, 9.78; 95% confidence interval, 3.02–31.63). In 14 (66.7%) eyes with retinal tear, the mean number of VHDs significantly decreased from 23.2 ± 20.27 to 2.3 ± 2.66 at a mean follow-up interval of 2.8 ± 1.48 weeks (P = 0.002).Conclusions: The presence of severe VHDs is suggestive of retinal tear in patients with acute symptomatic PVD. However, this SD-OCT finding should be limited to the acute phase of PVD.

The incidence of retinal breaks in the presenting and fellow eyes in patients with acute symptomatic posterior vitreous detachment and their associated risk factors.

To determine the incidence of retinal breaks in presenting and fellow eyes in patients with acute symptomatic posterior vitreous detachment (PVD) and their associated risk factors. A prospective study of 101 consecutive patients presenting with acute symptomatic PVD. The PVD status and other relevant ophthalmic findings were noted for both presenting and fellow eyes at initial presentation. Patients with PVD in the fellow eye were followed up appropriately whereas those without were invited to return for a further examination 4 years later. Data analysis was performed using general linear model and logistic regression. The mean age was 62 years. Seventy-six eyes had PVD in the presenting eyes, which were more myopic than their fellow eyes. Increased myopia and the presence of vitreous and/or retinal hemorrhage were associated with the presence of retinal tear(s) (P = 0.03 and P < 0.0001, respectively) at presentation. Twenty-three of the presenting eyes and 2 of the fellow eyes had have retinal break(s) at the first clinic visit. Of those, 14 eyes were found not to have a visible Weiss ring. Only 5.9% of the eyes (3 presenting eyes and 3 fellow eyes) developed delayed retinal break(s). Acute symptomatic PVD is a common presentation. It is essential to perform thorough examination to both presenting eye and fellow eye at initial presentation and follow-up appointments to prevent delay of treatment to retinal break(s).

Acute symptomatic posterior vitreous detachment and delayed retinal breaks

Acute symptomatic posterior vitreous detachment and delayed retinal breaks

Prevalence of retinal tears in an optometric population

The prevalence of fresh retinal tears and acute symptomatic posterior vitreous detachment (PVD) was determined for a metropolitan optometric population by retrospectively examining the records of 2...

Optic disc haemorrhages in posterior vitreous detachment

Posterior vitreous detachment (PVD) is a common clinical entity but is not often associated with a significant ocular disorder. Optic disc haemorrhages are rarely associated with a PVD and are more commonly associated with other local or systemic disease. The symptoms of a PVD, combined with a careful examination of the vitreoretinal interface allows a confident diagnosis of secondary disc haemorrhage to be made. Two cases of acute symptomatic PVD complicated by disc haemorrhage are presented.

Complications of Acute Symptomatic Posterior Vitreous Detachment

During a ten-year period, 172 eyes of 155 patients developed acute symptomatic posterior vitreous detachments. The study included only patients examined within three months of the onset of symptoms. The patients ranged in age from 22 to 82 years, with an average age of 60 years. Of the 172 eyes, 118 (69%) developed no retinal or vitreous complications. Retinal tears occurred in 14 eyes (8%) and vitreous or retinal hemorrhages occurred in 36 eyes (21%). Seventeen patients (11%) who had acute symptomatic posterior vitreous detachment in one eye later developed acute symptomatic posterior vitreous detachment in the fellow eye. The second posterior vitreous detachment developed within two years of the first one in 15 eyes (88%). In 13 patients (76%), the second eye responded in the same manner to the posterior vitreous detachment as had the first, that is, ten pairs of eyes had no further complications, two pairs had retinal or vitreous hemorrhages, and one pair had retinal breaks.