Vitreous Changes Research Articles

Signs and symptoms of uveitis

SummaryUveitis can be a sight‐threatening disease. In ammation of uveal tract can be divided into: anterior, intermediate, posterior, and panuveitis. Blurred vision, ocular pain, photophobia and oaters are some of the symptoms complained by those who are a ected by uveitis. e onset of uveitis can be either acute or insidious, bilateral rather than unilateral. Posterior uveitis is usually associated with vitritis. Anterior chamber cells and are should be graded according to standardized uveitis nomenclature (SUN) working group. Binocular indirect ophthalmoscopy (BIO) score is used to evaluate the severity of vitritis. Vitreous changes may comprehend: vitreous hemorrhage, vitreous strands, and vitreous traction. A further classi cation of posterior uveitis depends on the primary site of in ammation, which can identify: retinitis, choroiditis, retinochoroiditis, and chorioretinitis. Posterior pole uveal involvement can be: focal, multifocal, and placoid. Retinal vasculitis can be present. Uveitis might be complicated by anterior and posterior synechiae, which can lead to uveitic glaucoma, cystoid macular oedema, retinal and choroidal neovascularizations, and retinal ischemia.

PH of anti-VEGF agents in the human vitreous: low impact of very different formulations

Background The aim of the study was to measure pH changes of the human vitreous caused by the intravitreal drugs bevacizumab, ranibizumab, aflibercept, and ziv-aflibercept.MethodsFresh human vitreous samples were obtained during core vitrectomy (23-gauge) from patients with epiretinal gliosis. Aliquots of bevacizumab, ranibizumab, aflibercept or ziv-aflibercept (2 µl) were added consecutively to 200 µl of vitreous samples or 0.9% NaCl saline. The pH was measured using a pH-sensitive microelectrode. Rituximab, in off-label use against intraocular lymphoma, was tested as an IgG1 antibody.ResultsThe pH of the administered drugs was 5.91 for bevacizumab (95% CI 5.63–6.19), 5.32 for ranibizumab (95% CI 5.0–5.63), 6.05 for aflibercept (95% CI 5.78–6.31), ziv-aflibercept 6.1 (95% CI 6.05–6.15), and 6.29 for rituximab (95% CI 5.97–6.61). While the fresh and undiluted vitreous fluid showed pH values of 7.0–7.4, pH values increased if saline or rituximab were added. In contrast, the pH decreased slightly if aflibercept, bevacizumab, ranibizumab or ziv-aflibercept were supplemented. The observed pH decreases were not significant after ranibizumab was added. Significant changes were only notable with higher-than-normal amounts of bevacizumab (26–40 µl). The vitreous showed the most robust buffering capacity towards ranibizumab and rituximab.ConclusionsThe pH changes in vitreous samples elicited by the usual intravitreal anti-VEGF drugs differed clearly, but only by much higher concentrations than used in the clinical routine. Although the ingredient solution of ranibizumab showed the lowest pH, it caused only moderate changes of vitreal pH compared to bevacizumab, aflibercept or ziv-aflibercept.

Nd:YAG laser vitreolysis versus pars plana vitrectomy for vitreous floaters.

The vitreous is the clear jelly of the eye and contains fine strands of proteins. Throughout life the composition of this vitreous changes, which causes the protein strands in it to bundle together and scatter light before it reaches the retina. Individuals perceive the shadows cast by these protein bundles as 'floaters'. Some people are so bothered by floaters that treatment is required to control their symptoms. Two major interventions for floaters include Nd:YAG laser vitreolysis and vitrectomy. Nd:YAG laser vitreolysis involves using laser energy to fragment the vitreous opacities via a non-invasive approach. Vitrectomy involves the surgical replacement of the patient's vitreous (including the symptomatic vitreous floaters) with an inert and translucent balanced salt solution, through small openings in the pars plana. To compare the effectiveness and safety of Nd:YAG laser vitreolysis to pars plana vitrectomy for symptomatic vitreous floaters. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (which contains the Cochrane Eyes and Vision Trials Register) (2016, Issue 12), MEDLINE Ovid (1946 to 17 January 2017), Embase Ovid (1947 to 17 January 2017), LILACS (Latin American and Caribbean Health Sciences Literature Database) (1982 to 17 January 2017), the ISRCTN registry (www.isrctn.com/editAdvancedSearch); searched 17 January 2017, ClinicalTrials.gov (www.clinicaltrials.gov); searched 17 January 2017 and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en); searched 17 January 2017. We did not use any date or language restrictions in the electronic searches for trials. We also searched conference proceedings to identify additional studies. We included only randomised controlled trials (RCTs) that compared Nd:YAG laser vitreolysis to pars plana vitrectomy for treatment of symptomatic floaters. We planned to use methods recommended by Cochrane. The primary outcome we planned to measure was change in vision-related quality of life from baseline to 12 months, as determined by a vision-related quality of life questionnaire. The secondary outcomes we planned to measure were best corrected logMAR or Snellen visual acuity at 12 months for the treated eye(s) and costs. Adverse outcomes we planned to record were the occurrence of sight-threatening complications by 12 months (asymptomatic retinal tears, symptomatic retinal tears, retinal detachment, cataract formation, and endophthalmitis). No studies met the inclusion criteria of this review. There are currently no RCTs that compare Nd:YAG laser vitreolysis with pars plana vitrectomy for the treatment of symptomatic floaters. Properly designed RCTs are needed to evaluate the treatment outcomes from the interventions described. We recommend future studies randomise participants to either a Nd:YAG laser vitreolysis group or a vitrectomy group, with participants in each group assigned to either receive treatment or a sham intervention. Future studies should follow participants at six months and 12 months after the intervention. Also they should use best corrected visual acuity (BCVA) using an Early Treatment of Diabetic Retinopathy Study (ETDRS) chart read at 4 metres, vision-related quality of life (VRQOL), and adverse outcomes as the outcome measures of the trial.

Ultrasound biomicroscopic imaging in paediatric ocular toxocariasis

PurposeTo determine the potential and usefulness of ultrasound biomicroscopy (UBM) as a diagnostic procedure on a larger cohort of paediatric patients with ocular toxocariasis.MethodsUBM was performed on 41 eyes of...

Elaboration and Characterization of Glasses and Ceramic-Glasses within Theternary Diagram Li<sub>2</sub>O-Cr<sub>2</sub>O<sub>3</sub>-P<sub>2</sub>O<sub>5</sub>

Use of the regular melting-quench method allowed the isolation of a small glass domain within the ternary system Li2O-P2O5-Cr2O3 at 1000°C. Electrical conductivity and dielectric permittivity measures on sample glasses and ceramic glasses of this domain were performed at a frequency of 10 kHz and at temperatures between 25°C and 300°C. The values of dielectric permittivity and electrical conductivity increase with increasing Li2O content. However, increases of Cr2O3 content, even at low concentrations, induce a change in electrical conductivity behaviour from that of a glass to that of a ceramic glass. The introduction of an increasing amount of Li2O content in vitreous phosphorus pentoxide changes its three-dimensional network; rupture of the P-O-P bond then occurs and there is formation of easily polarisable entities with quite high values of . The vibrational spectroscopy technique I.R has allowed an efficient investigation of the structural change versus composition within the above indicated ternary diagram. The maximal dielectric permittivity obtained at 300°C, both for the glasses and for the ceramic glasses varied in the order 104 to 3 × 105, while the maximum electrical conductivity obtained at 300°C for the ceramic glasses was in the order of 10-3 Ωcm-1.

Early Postnatal Hyperoxia in Mice Leads to Severe Persistent Vitreoretinopathy.

To describe a mouse model of hyperoxia-induced vitreoretinopathy that replicated some of the clinical and pathologic features encountered in infants with severe retinopathy of prematurity and congenital ocular conditions such as persistent hyperplastic primary vitreous. Experimental mice (C57BL/6J) were exposed to 65% oxygen between postnatal days (P)0 to P7 and studied at P10, P14, and 3, 5, 8, 20, and 40 weeks. Controls were exposed to normoxic conditions. Fundus imaging and fluorescein angiography were performed at all time points, and spectral-domain optical coherence tomography (SD-OCT) and electroretinography were performed at 8- and 20-week time points. Eyes were processed for resin histology, frozen sections, and retinal whole mounts. Immunostaining was performed to visualize vasculature isolectin B4 (Ib4), collagen type IV, glial fibrillary acidic protein, and α-smooth muscle actin. Early exposure to hyperoxia resulted in bilateral vitreous hemorrhages at 3 weeks. From 5 weeks onward there were extensive zones of retinal degeneration, scarring or gliosis, retinal folding, and detachments caused by traction of α-smooth muscle actin-positive vitreous membranes. Tortuous retinal vessels, together with hyperplastic and persistence of hyaloid vessels are evident into adulthood. In the early stages (P10-3 weeks), branches from the tunica vasculosa lentis (TVL) supplied the marginal retina until retinal vessels were established. The peripheral retina remained poorly vascularized into adulthood. Electroretinography revealed 50% to 60% diminution in retinal function in adult mice that strongly correlated with vitreal changes identified using SD-OCT. This animal model displays a mixture of vitreoretinal pathologic changes that persist into adulthood. The model may prove valuable in experimental investigations of therapeutic approaches to blinding conditions caused by vitreous and retinal abnormalities.

Evaluation of Biochemical Composition of Vitreous of Eyes of Diabetic Patients Using Proton Magnetic Resonance Spectroscopy

ABSTRACTPurpose: To investigate possible metabolic changes in vitreous of patients with diabetes mellitus with or without diabetic retinopathy using proton magnetic resonance spectroscopy.Material and methods: Twenty-eight healthy control subjects (group 1), 18 patients with diabetes mellitus without diabetic retinopathy (group 2) and 18 patients with diabetic retinopathy (group 3) were included. Proton magnetic resonance spectroscopy was performed in left vitreous of all subjects; amounts of Glutamate, Choline, Lactate and Creatine values were measured. Choline/Creatine, Glutamate/Creatine and Lactate/Creatine ratios were calculated.Results: Glutamate/Creatine and Lactate/Creatine ratios were significantly higher in group 2 and 3 when compared to group 1. Both Glutamate/Creatine and Lactate/Creatine ratios did not show any difference in group 2 when compared to group 3.Conclusions: Our results suggest that when compared to healthy subjects, Glutamate and Lactate are the main metabolites of vitreous in diabetes mellitus patients. This may help us to better understand the metabolic factors in pathogenesis of diabetic retinopathy.

Signs and symptoms of uveitis

SummaryUveitis can be a sight‐threatening disease. Inflammation of uveal tract can be divided into: anterior, intermediate, posterior, and panuveitis. Blurred vision, ocular pain, photophobia and floaters are some of the symptoms complained by those who are affected by uveitis. The onset of uveitis can be either acute or insidious, bilateral rather than unilateral. Posterior uveitis is usually associated with vitritis. Anterior chamber cells and flare should be graded according to standardized uveitis nomenclature (SUN) working group. Binocular indirect ophthalmoscopy (BIO) score is used to evaluate the severity of vitritis. Vitreous changes may comprehend: vitreous hemorrhage, vitreous strands, and vitreous traction. A further classification of posterior uveitis depends on the primary site of inflammation, which can identify: retinitis, choroiditis, retinochoroiditis, and chorioretinitis. Posterior pole uveal involvement can be: focal, multifocal, and placoid. Retinal vasculitis can be present. Uveitis might be complicated by anterior and posterior synechiae, which can lead to uveitic glaucoma, cystoid macular oedema, retinal and choroidal neovascularizations, and retinal ischemia.

Contact Lens Methods for Clinical Myopia Control.

A number of optical methods for slowing myopia progression have been tested and are now available. However, data on real-world use in clinical use is scarce. Here, we present a review of the clinical outcomes for patients attending a specialist myopia control clinic at The University of Auckland Optometry School, NZ. We report a comparative case series of 110 patients (aged 4-33 years, mean: 12.13 ± 4.58 years, 62% female) who attended the clinic between 2010 and 2014. Fifty-six were prescribed orthokeratology, 32 dual focus soft contact lenses, and 22 received advice only. Initial myopia, vitreous and axial eye length, previous myopia progression, age, number of myopic parents, and gender were not significantly different between orthokeratology and dual focus soft contact lens groups. Mean follow-up time for the orthokeratology and dual focus lens groups was the same (orthokeratology: 1.30 ± 0.88 years; dual focus lens: 1.33 ± 0.80 years (p = 0.989)). There was a significant reduction in the annualized myopia progression in both groups (orthokeratology: -1.17 ± 0.55 to -0.09 ± 017 D/yr, p < 0.001; dual focus soft contact lens: -1.15 ± 0.46 to -0.10 ± 0.23 D/yr, p < 0.001). There was no difference between orthokeratology and dual focus lens treatment efficacy (p = 0.763), nor in axial or vitreous chamber length changes after treatment (p = 0.184). One adverse event was reported over the 4-year period. Both orthokeratology and dual focus soft contact lenses are effective strategies for targeting myopia progression in the clinic. We saw no significant difference in the efficacy of the two methods in this regard, and so we believe there are very few barriers for any contact lens practitioner to be actively promoting myopia control treatment to at-risk patients.

Spatial Variations in Vitreous Oxygen Consumption.

We investigated the spatial variation of vitreous oxygen consumption in enucleated porcine eyes. A custom made oxygen source was fabricated that could be localized to either the mid or posterior vitreous cavity and steady state vitreous oxygen tension was measured as a function of distance from the source using a commercially available probe. The reaction rate constant of ascorbate oxidation was estimated ex vivo by measuring the change in oxygen tension over time using vitreous harvested from porcine eyes. Vitreous ascorbate from mid and posterior vitreous was measured spectrophotometrically. When the oxygen source was placed in either the mid-vitreous (N = 6) or the posterior vitreous (N = 6), we measured a statistically significant decrease in vitreous oxygen tension as a function of distance from the oxygen source when compared to control experiments without an oxygen source; (p<0.005 for mid-vitreous and p<0.018 for posterior vitreous at all distances). The mid-vitreous oxygen tension change was significantly different from the posterior vitreous oxygen tension change at 2 and 3mm distances from the respective oxygen source (p<0.001). We also found a statistically significant lower concentration of ascorbate in the mid-vitreous as compared to posterior vitreous (p = 0.02). We determined the reaction rate constant, k = 1.61 M-1s-1 ± 0.708 M-1s-1 (SE), of the oxidation of ascorbate which was modeled following a second order rate equation. Our data demonstrates that vitreous oxygen consumption is higher in the posterior vitreous compared to the mid-vitreous. We also show spatial variations in vitreous ascorbate concentration.

Embryological aspects of clinical presentations of congenital lens and vitreous anomalies

This report gives a general overview of embryological features of the human eye. Key literature sources published during the last century on evaluation of congenital changes in the vitreous body and identification of signs of its 'underdevelopment' in certain types of congenital cataracts have been studied. The said changes were analyzed in terms of general pathology of the human body as well as local morphological manifestations. According to the authors, such an approach justifies the need for comparison of clinical manifestations of congenital lens and vitreous changes with possible embryonic defects.

SINGLE ACQUISITION OF THE VITREOUS, RETINA AND CHOROID WITH SWEPT-SOURCE OPTICAL COHERENCE TOMOGRAPHY IN ACUTE TOXOPLASMOSIS

To report the swept-source optical coherence tomography (SS-OCT) findings in a case of acute toxoplasmosis chorioretinitis. A 35-year-old male presented with acute blurry vision and floaters in his left eye. Ophthalmic examination, color photographs, spectral-domain OCT (SD-OCT), enhanced depth imaging OCT (EDI-OCT), SS-OCT and wide-field fluorescein angiography images were obtained to diagnose and follow the subsequent changes of toxoplasmosis chorioretinitis over a 2-month period. Initial imaging with different modalities of SD- and EDI-OCT including radial vitreous scans and horizontal high-speed B-scan raster lines demonstrated thickening of the posterior hyaloid and acute vitreous cells emanating from the retinal blood vessels, thickening and disorganization of the retinal layers within the chorioretinal lesion, and increased sub-lesional choroidal thickness, respectively. SS-OCT demonstrated all of these same findings in a single 12-mm B-scan. Topical steroids were initiated and imaging over the next 2 months showed separation of the posterior hyaloid, decrease in vitreous cell, and atrophy of the chorioretinal lesion. We report the first SS-OCT images of an acute case of toxoplasmosis chorioretinitis. SS-OCT can visualize the choroidal, retinal, and vitreous changes in a single scan, compared with the different imaging algorithms required with SD-OCT.

Investigation of Electrolyte Changes in Bovine Vitreous at Different Postmortem Interval

Objective: Investigation of the changes in electrolyte level in the Bovine vitreous at different postmortem interval under two different temperature conditions. Methods: Ninety eight bovine right eyes from freshly slaughtered healthy cows were gotten from the government abattoir in Edo State, Nigeria. They were divided into two sets; forty nine right eyes were kept at 32°C while forty nine right eyes were kept at 4°C in a mobile refrigerator. The samples of vitreous were carefully aspirated from the bovine eyes within an hour of death of the animals. Measurements of the levels of cations (sodium and potassium) and anions (chloride and bicarbonate) were taken at various postmortem intervals of 2, 12, 24, 36, 48, 60 and 72 hours, using E110111 Flame Photometer. Results: There was a statistically significant increase (p<0.05) in the potassium ion level with increased postmortem interval (PMI) at 4°C and 32°C. There were significant reductions (p<0.05) in sodium, chloride and bicarbonate ion levels with increased postmortem interval at 32°C, but at 4°C, the reduction in chloride ion level was not significant. The results also showed that the changes in cations and anions levels varied under the two temperature conditions after death. Conclusion: The level of potassium ion increased after death, but sodium, chloride and bicarbonate ion levels in the vitreous humour of bovine eyes decreased after death. Likewise temperature affected the level of anions and cations in the bovine vitreous after death.

Immunopathogenic Background of Pars Planitis.

Pars planitis is defined as an intermediate uveitis of unknown background of systemic disease with characteristic formations such as vitreous snowballs, snowbanks and changes in peripheral retina. The incidence of pars planitis varies 2.4–15.4 % of the uveitis patients. The pathogenesis of the disease is to be determined in future. Clinical and histopathological findings suggest an autoimmune etiology, most likely as a reaction to endogenous antigen of unknown source, with T cells predominant in both vitreous and pars plana infiltrations. T cells subsets play an important role as a memory-effector peripheral cell. Snowbanks are formed as an effect of post inflammatory glial proliferation of fibrous astrocytes. There is also a genetic predisposition for pars planitis by human leukocyte antigen and several other genes. A coexistence of multiple sclerosis and optic neuritis has been described in numerous studies. Epiretinal membrane, cataract, cystoid macular edema, retinal detachment, retinal vasculitis, neovascularization, vitreous peripheral traction, peripheral hole formation, vitreous hemorrhage, disc edema are common complications observed in pars planitis. There is a need to expand the knowledge of the pathogenic and immunologic background of the pars planitis to create an accurate pharmacological treatment.

Signs and symptoms of uveitis

SummaryInflammation of uveal tract can be divided into: anterior, intermediate, posterior, and panuveitis. Uveitis can be a sight‐threatening disease. The commonest ocular symptoms are: blurred vision, ocular pain, photophobia and floaters, depending on the type of uveitis. The onset of uveitis can be either acute or insidious, involving one or both eyes. Posterior uveitis is usually associated with vitritis. Anterior chamber cells and flare should be graded according to standardized uveitis nomenclature (SUN) working group. Binocular indirect ophthalmoscopy (BIO) score is used to grade vitreous involvement. Vitreous changes may comprehend: vitreous hemorrhage, vitreous strands, and vitreous traction. A further classification of posterior uveitis depends on the primary site of inflammation, which can identify: retinitis, choroiditis, retinochoroiditis, and chorioretinitis. Posterior pole uveal involvement can be: focal, multifocal, and placoid. Retinal vasculitis can be associated with several sub‐types of posterior uveitis. Uveitis can present several complications such as, anterior and posterior synechiae, which can lead to uveitic glaucoma, cystoid macular oedema, retinal and choroidal neovascularizations, and retinal ischemia.

Orthokeratology to control myopia progression: a meta-analysis.

ObjectiveTo evaluate the clinical treatment effects of orthokeratology to slow the progression of myopia.MethodsSeveral well-designed controlled studies have investigated the effects of orthokeratology in school-aged children. We conducted this meta-analysis to better evaluate the existing evidence. Relevant studies were identified in the Medline and Embase database without language limitations. The main outcomes included axial length and vitreous chamber depth reported as the mean ± standard deviation. The results were pooled and assessed with a fixed-effects model analysis. Subgroup analyses were performed according to geographical location and study design.ResultsOf the seven eligible studies, all reported axial length changes after 2 years, while two studies reported vitreous chamber depth changes. The pooled estimates indicated that change in axial length in the ortho-k group was 0.27 mm (95% confidence interval [CI]: 0.22, 0.32) less than the control group. Myopic progression was reduced by approximately 45%. The combined results revealed that the difference in vitreous chamber depth between the two groups was 0.22 mm (95% confidence interval [CI]: 0.14, 0.31). None of the studies reported severe adverse events.ConclusionThe overall findings suggest that ortho-k can slow myopia progression in school-aged children.

Low prevalence of anterior vitreous detachment in eyes with pseudophakic retinal detachment indicates strong vitreoretinal adhesions

Rhegmatogenous retinal detachment (RRD) occurs more frequently in pseudophakic eyes than in phakic eyes (Coppé & Lapucci 2008). This phenomenon is presumably based on the acceleration of posterior vitreous detachment (PVD) after cataract surgery secondary to postoperative vitreous changes (Ueno et al. 1987; Neal et al. 2005; Ivastinovic et al. 2012). The etiological retinal tears commonly develop in areas with strong vitreoretinal adhesions which need to be released during vitrectomy. According to our personal experience, pseudophakic eyes with RRD show a firm adherence of the anterior hyaloid to the posterior lens capsule. To objectify our personal observation, we assessed the anterior vitreous with optical coherence tomography (OCT) (Figs 1 and 2). The contribution of anterior vitreous in the development of RRD remains unknown, however. The aim of our study was to compare the prevalence of anterior vitreous detachment (AVD) in pseudophakic eyes with RRD and without RRD serving as controls. This prospective controlled study was approved by the ethics committee of the Medical University Graz, Austria. We recruited patients at the Department of Ophthalmology, Medical University Graz, between June 2013 and September 2014. Pseudophakic patients undergoing vitrectomy for RRD were enrolled in the study group, and pseudophakic patients undergoing cataract surgery on their fellow eye were enrolled in the control group. Exclusion criteria were previous surgeries including scleral buckle or vitrectomy, previously performed Nd:YAG capsulotomy, intra-operative capsule rupture or a history of ocular trauma. The anterior vitreous was assessed with High-Definition-OCT (Cirrus™; Carl Zeiss Meditec, Jena, Germany) using the anterior segment cube 512 × 128 adjustment. All patients were examined after full pupil dilation with mydriatic drops. Particular attention was paid to the interface between the anterior vitreous cortex and the posterior lens capsule. In the control group, the status of the posterior hyaloid was additionally assessed using the macular cube 512 × 128 adjustment. Descriptive statistics were presented as mean ± standard deviation. Normal distribution was assessed with the Kolmogorov–Smirnov test. The appropriate statistical method was depicted where suitable. The threshold for statistical significance was defined as p < 0.05. Overall, 55 eyes of 55 patients were enrolled in the study. The study group included 24 patients (3 female; 21 male); the control group comprised 31 patients (13 female and 18 male). The age of patients averaged 69.1 ± 11.2 years in the study group and 70.8 ± 9.4 years in the control group (p = 0.61, independent t-test). Phacoemulsification was performed 25.5 ± 48.5 months prior to the examination in the study group and 21.9 ± 29.5 months in the control group (p = 0.45, Mann–Whitney U-test). AVD was diagnosed in 8.3% (n = 2) in the study group and 25.8% (n = 8) in the control group (p = 0.03, Fisher's exact test). In both groups, there was no association between AVD and the duration of pseudophakia. In the control group, complete PVD was noted in 51.6% (n = 16), incomplete PVD in 35.5% (n = 11) and no PVD in 12.9% (n = 4). AVD in this group was only observed in eyes with complete PVD. Our study demonstrates that pseudophakic eyes with RRD have a significantly lower prevalence of AVD compared to pseudophakic control eyes. Accordingly, the persistent attachment of the anterior hyaloid to the posterior lens capsule probably indicates a strong vitreoretinal adherence which plays a crucial role in the development of postphacoemulsification RRD. The elapsed time after cataract surgery did not seem to affect the prevalence of AVD. The fact that in the control group, AVD was only observed in eyes with complete PVD confirms the assumed relation between the strong vitreoretinal adhesion and the persistent attachment of the anterior hyaloid. The evaluation of the role of anterior vitreous in the development of RRD was beyond the scope of this study. In conclusion, the low prevalence of AVD in eyes with pseudophakic RRD suggests strong vitreoretinal adhesions which have probably provoked the development of retinal tears and subsequently RRD in the course of postoperative PVD.

Clinicopathological correlations at the vitreoretinal interface

Clinicopathological studies of the vitreoretinal interface (VRI) improve our understanding of the pathogenesis of vitreal maculopathy, facilitate differential diagnoses and help to develop new treatment strategies. The aim of the study was to provide a comprehensive overview on clinicopathological correlations of the VRI. A semi-structured literature search was performed in the Medline and Embase databases for relevant original studies on clinicopathological correlations of vitreal maculopathy, in addition to the latest books and review articles. Age-related vitreous changes with persistent vitreomacular adhesions on the retinal surface promote cellular migration and proliferation onto the vitreal side of the internal limiting membrane (ILM), thereby cementing the vitreomacular adhesions and strengthening the traction forces on retinal layers. Cellular or fibrocellular proliferation at the vitreomacular interface can be seen in all vitreal maculopathies. Furthermore, vitreoschisis in the context of anomalous posterior vitreous detachment causes the presence of vitreous cortex collagen fibrils on the vitreal side of the ILM which is associated with epiretinal membrane formation. Glial cells, hyalocytes and myofibroblasts represent the major cell types in the epiretinal cell proliferation. Glial cells and hyalocytes are capable of transdifferentiation into myofibroblasts which possess strong contractive properties and are well known for the production of extracellular matrix components. Removing vitreomacular adhesions and vitreous cortex collagen fibrils from the retinal surface is most important for successful treatment. In cases with epiretinal cell proliferation, however, removal of the ILM during macular surgery is mandatory to avoid reproliferation and recurrence. Improving the detection of epiretinal cell proliferation and cell distribution in patient eyes by optical coherence tomography or by introduction of new technologies should be addressed in the future.

Distortion of vitreous structure in eyes with lens dislocation

to study the range of structural changes in the vitreous and to determine spatial position of the lens in case of its dislocation. A total of 47 patients (94 eyes) with so-called senile cataract aged from 59 to 83 years were examined. The state of the vitreous was evaluated by means of digital ultrasound examination. Combined structural changes in the basis and cortex of the vitreous in eyes with lens and/or its elements dislocation have been analyzed. The possibility of lens evaluation in terms of its integrity and topography as well as spatial position of its elements has been shown. The relationship between the vitreous and lens changes has also been established. Digital ultrasound examination is capable of producing a 3D image of the eye, thus, allowing to assess spatial defects of the vitreous and to determine the position of the lens in case of its dislocation.

Signs and symptoms of uveitis

AbstractInflammation of uveal tract can be divided into: anterior, intermediate, posterior, and panuveitis. Uveitis can be a sight‐threatening disease. The commonest ocular symptoms are: blurred vision, ocular pain, photophobia and floaters, depending on the type of uveitis. The onset of uveitis can be either acute or insidious, involving one or both eyes. Posterior uveitis is usually associated with vitritis. Anterior chamber cells and flare should be graded according to standardized uveitis nomenclature (SUN) working group. Binocular indirect ophthalmoscopy (BIO) score is used to grade vitreous involvement. Vitreous changes may comprehend: vitreous hemorrhage, vitreous strands, and vitreous traction. A further classification of posterior uveitis depends on the primary site of inflammation, which can identify: retinitis, choroiditis, retinochoroiditis, and chorioretinitis. Posterior pole uveal involvement can be: focal, multifocal, and placoid. Retinal vasculitis can be associated with several sub‐types of posterior uveitis. Uveitis can present several complications such as, anterior and posterior synechiae, which can lead to uveitic glaucoma, cystoid macular oedema, retinal and choroidal neovascularizations, and retinal ischemia.