Vitreous Opacities Research Articles

Neodymium yttrium aluminum garnet (Nd: YAG) laser vitreolysis versus oral iodized lecithin tablets for the management of symptomatic vitreous opacities

Neodymium yttrium aluminum garnet (Nd: YAG) laser vitreolysis versus oral iodized lecithin tablets for the management of symptomatic vitreous opacities

Traumatic terson syndrome with a peculiar mass lesion and tractional retinal detachment: a case report

BackgroundTo report a case with bilateral Terson syndrome presented with a unique mushroom-like mass lesion on the optic disc along with proliferative vitreoretinopathy and tractional retinal detachment.Case presentationA 33-year-old man was injured during a traffic accident and had diffuse brain swelling and intraocular hemorrhage. Poor vision in both eyes was noted after the patient regained consciousness. B-scan ultrasonography showed extensive vitreous opacity with a posterior vitreous detachment and without obvious retinal detachment. Vitrectomy was performed in both eyes five months after the accident. After clearing up the vitreous opacity, a peculiar pigmented mushroom-like mass lesion was noted in the posterior pole and had severe adhesion to the underneath optic disc. Extensive multilayered peripapillary epiretinal membrane was found covering the posterior pole and led to tractional retinal detachment around the macula. The mass was presumed to be an organized vitreous hemorrhage originated from the optic disc. The extensive and adherent epiretinal membrane together with the mass lesion were removed as much as possible and silicon oil was injected for tamponade. However, in the right eye, the retina redetached under silicon oil, whereas in the left eye, his vision improved to 20/100.ConclusionsTerson syndrome usually has a favorable prognosis but may be complicated by proliferative vitreoretinopathy and tractional retinal detachment. Careful monitoring is warranted and early vitrectomy should be considered in cases suspecting additional pathologies.

A case report: co-occurrence of probable Vogt-Koyanagi-Harada disease and diabetic retinopathy

BackgroundBilateral retinal detachment and choroidal detachment in a patient are rare occurrences. The presence of bilateral diabetic retinopathy (DR) in such a case is even rarer and complicates the condition.Case presentationIn this study, we document a case of unconventional VKH. Manifestations in this patient included intense peripheral retinal detachment and choroidal detachment, along with vitreous opacities akin to cotton wool spots, concurrent with DR. The diagnosis was considered as probable VKH with DR. Treatment according to VKH protocols, including high-dose corticosteroids, yielded positive results.ConclusionsVKH can co-occurrence with DR. VKH manifestations vary, and early, aggressive, and long-term treatment is essential. The complexity of treatment increases with concurrent DR, necessitating the use of immunosuppressants.

The role of ultra-widefield imaging with navigated central and peripheral cross-sectional and three-dimensional swept source optical coherence tomography in ophthalmology: Clinical applications.

To assess central and peripheral retinal and choroidal diseases using ultra-widefield (UWF) fundus imaging in combination with navigated central and peripheral cross-sectional and three-dimensional (3D) swept source optical coherence tomography (SS-OCT) scans. Retrospective study involving 332 consecutive patients, with a nearly equal distribution of males and females. The mean age of patients was 52 years (range 18-92 years). Average refractive error was -3.80 D (range +7.75 to -20.75 D). The observations in this study demonstrate the efficacy of peripheral navigated SS-OCT in assessing various ocular conditions. The technology provides high-quality images of the peripheral vitreous, vitreoretinal interface, retina, and choroid, enabling visualization of vitreous floaters and opacities, retinal holes and tears, pigmented lesions, and peripheral retinal degenerations. 3D OCT scans enhance the visualization of these abnormalities and improve diagnostic and therapeutic decisions. Navigated central and peripheral cross-sectional and 3D SS-OCT scans offer significant complementary benefits in the assessment and management of retinal diseases. Their addition to UWF imaging provides a comprehensive view of central and peripheral ocular structures, aiding in early detection, precise anatomical measurements, and objective monitoring of disease progression. In addition, this technology serves as a valuable tool for patient education, a teaching tool for trainees, and documentation for medico-legal purposes.

Forward Light Scattering of the Vitreous Gel After Enzymatic Aging: An In Vitro Model to Study Vitreous Opacification.

Symptomatic vitreous opacifications, so-called floaters, are difficult to objectively assess majorly limiting the possibility of in vitro studies. Forward light scattering was found previously to be increased in eyes with symptomatic floaters. Using an objective setup to measure forward light scattering, we studied the effects of enzymatically digesting the components of the vitreous body on straylight to develop an in vitro model of vitreous opacifications. Fifty-seven porcine vitreous bodies were digested using hyaluronidase, collagenase, trypsin, and bromelain, as well as using a combination of hyaluronidase + collagenase and hyaluronidase + bromelain. A modified C-Quant setup was used to objectively assess forward light scattering. Depletion of hyaluronic acid majorly increased vitreous straylight (mean increase 34.4 deg2/sr; P = 0.01), whereas primarily digesting the vitreous gel with collagenase or trypsin did not significantly affect straylight. When collagenase or bromelain is applied in hyaluronic acid depleted vitreous gels, the increase in forward light scattering is reversed partially. The age-related loss of hyaluronic acid primarily drives the increase in vitreous gel straylight induced by conglomerates of collagen. This process can be reversed partially by digesting collagen. This in vitro model allows the objective quantification and statistical comparison of straylight burden caused by vitreous opacities and, thus, can serve as a first testing ground for pharmacological therapies, as demonstrated with bromelain.

Immune Analysis Using Vitreous Optical Coherence Tomography Imaging in Rats with Steroid-Induced Glaucoma.

Glaucoma is a multifactorial pathology involving the immune system. The subclinical immune response plays a homeostatic role in healthy situations, but in pathological situations, it produces imbalances. Optical coherence tomography detects immune cells in the vitreous as hyperreflective opacities and these are subsequently characterised by computational analysis. This study monitors the changes in immunity in the vitreous in two steroid-induced glaucoma (SIG) animal models created with drug delivery systems (microspheres loaded with dexamethasone and dexamethasone/fibronectin), comparing both sexes and healthy controls over six months. SIG eyes tended to present greater intensity and a higher number of vitreous opacities (p < 0.05), with dynamic fluctuations in the percentage of isolated cells (10 µm2), non-activated cells (10-50 µm2), activated cells (50-250 µm2) and cell complexes (>250 µm2). Both SIG models presented an anti-inflammatory profile, with non-activated cells being the largest population in this study. However, smaller opacities (isolated cells) seemed to be the first responder to noxa since they were the most rounded (recruitment), coinciding with peak intraocular pressure increase, and showed the highest mean Intensity (intracellular machinery), even in the contralateral eye, and a major change in orientation (motility). Studying the features of hyperreflective opacities in the vitreous using OCT could be a useful biomarker of glaucoma.

Multimodal Imaging of Vitreo-Retinal Lymphoma: A Comprehensive Review

ABSTRACT Purpose Vitreoretinal lymphoma (VRL) is a rare lymphoma affecting the vitreous and the retina. Clinical diagnosis is challenging and often delayed and may lead to aggravated prognosis. This study aims to review multimodal imaging findings in VRL. Methods We performed a comprehensive narrative review of the multimodal imaging findings that might be useful in the detection of VRL lesions. Results The most frequent ocular manifestations of VRL are vitritis, and retinal and sub-retinal Pigmented Epithelium (RPE) infiltrations. Color Fundus Photography (CFP) detects vitreous haze, optic nerve, retinal and sub-RPE infiltration. Ultra-wide field imaging allows visualization of different patterns of vitreous haze and monitoring of VRL evolution through the detection of chorio-retinal atrophy (CRA). Fundus Autofluorescence shows granular hypo- and hyper-autofluorescent pattern. Optical Coherence Tomography (OCT) reveals vitreous cells, vertical hyper-reflective lesions and sub-RPE infiltrates. Fluorescein Angiography (FA) shows hypo or hyperfluorescent round lesions at the late stages of the examination, while Indocyanine Green Angiography (ICGA) detects round areas of focal hypo-fluorescence in the early phases that gradually enlarge in the late phases. B-scan ultrasonography detects vitreous opacities and homogeneous hyperreflective corpuscular material in the vitreous, and is a strongly recommended tool in suspecting VRL and is particularly useful when vitreous haze is impeding retinal examination. Conclusion Diagnostic vitrectomy with cytopathological analysis remains the gold standard for VRL diagnosis, however multimodal imaging allows the identification of suggestive retinal and vitreal lesions for early suspicion, diagnosis, and treatment and monitoring disease progression and response to treatment.

Ocular Signs and Testing Most Compatible with Sarcoidosis-Associated Uveitis: A Latent Class Analysis

PurposeThis study aims to explore the potential subgroups of sarcoidosis-associated uveitis (SAU) within a multicenter cohort of uveitis participants. DesignCross-sectional study. ParticipantsA cohort of 826 uveitis patients from a uveitis registry from 19 clinical centers in 12 countries between January 2011 and April 2015. MethodsWe employed a latent class analysis (LCA) incorporating recommended tests and clinical signs from the revised International Workshop on Ocular Sarcoidosis (IWOS) to identify potential SAU subgroups within the multicenter uveitis cohort. Additionally, we assessed the performance of the individual tests and clinical signs in classifying the potential subclasses. Main Outcome MeasuresLatent subtypes of SAU. ResultsAmong 826 participants included in this analysis, the two-class LCA model provided a best fit with the lowest BIC of 7218.7 and an entropy of 0.715. One class, consisting of 548 participants, represented the non-SAU while the second class, comprised of 278 participants, was most representative of SAU. Snowballs/string of pearls vitreous opacities had the best test performance for classification, followed by bilaterality and bilateral hilar lymphadenopathy (BHL). The combination of 4 tests with the highest classification importance, including snowballs/string of pearls vitreous opacities, periphlebitis and/or macroaneurysm, bilaterality, and BHL, demonstrated a sensitivity of 84.8% and a specificity of 95.4% in classifying the SAU subtypes. In the exploratory analysis of the 3-class LCA model, which had comparable fit indices as the 2-class model, we identified a candidate non-SAU subtype, candidate SAU subtype with pulmonary involvement, and a candidate SAU with less pulmonary involvement. ConclusionsLatent class modelling, incorporating tests and clinical signs from the revised IWOS criteria, effectively identified a subset of participants with clinical features indicative of SAU. Though the sensitivity of individual ocular signs or tests was not perfect, using a combination of tests provided a satisfactory performance in classifying the SAU subclasses identified by the 2-class LCA model. Notably, the classes identified by the 3-class LCA model, including a non-SAU subtype, an SAU subtype with pulmonary involvement, and an SAU subtype with less pulmonary involvement, may have potential implication for clinical practice and hence should be validated in further research.

Scleritis following intravitreal brolucizumab injection: a case series

BackgroundThis study reports the first cases of scleritis following intravitreal brolucizumab (IVBr) injection for nAMD, emphasizing the need to be aware of the possibility of scleritis following IVBr injections.Case presentationCase 1. A 74-year-old Japanese man with nAMD complained of conjunctivitis and decreased vision in the right eye 8 days after his eighth IVBr injection. Examination revealed scleritis without anterior inflammation. Topical 0.1% betamethasone and 0.3% gatifloxacin eye drops were started. The scleritis worsened in the following 2 weeks and became painful. He underwent sub-Tenon’s capsule triamcinolone acetonide (STTA) injection. Two days later, he returned with a complaint of severe vision loss. Fundus examination revealed retinal artery occlusion, vasculitis, and vitreous opacity in the right eye. Vitreous surgery was performed. Case 2. An 85-year-old Japanese woman with nAMD in the right eye complained of reddening of the eye 27 days after her fifth IVBr injection. Examination showed conjunctivitis and scleritis without anterior inflammation in the right eye. She was started on 0.1% fluorometholone and 0.5% levofloxacin hydrate eye drops. The scleritis worsened in the following 3 weeks. Her treatment was switched to 0.1% betamethasone eye drops. One month later, the scleritis had improved and a sixth IVBr injection was administered. There was no worsening of the scleritis at that time. However, 1 month after a seventh IVBr injection, she complained of severe hyperemia and decreased vision. Fundus examination revealed vitreous opacification. She underwent STTA, and the vitreous opacity improved in 24 days. Case 3. A 57-year-old Japanese man with nAMD complained of pain and decreased vision in the right eye 21 days after a fourth IVBr injection. Examination revealed scleritis with high intraocular pressure but no anterior chamber or fundus inflammation. STTA and topical eye drops were performed. One month later, scleritis improved but visual acuity didn’t due to progression of nAMD.ConclusionsIntraocular inflammation following IVBr injection may progress to the posterior segment. Scleritis can occur after IVBr injection, and topical eye drops alone may not be sufficient for initial treatment. Clinicians should consider the possibility of scleritis in patients with worsening inflammation after IVBr injection.

Vitreous Opacity Following Intravitreal Brolucizumab Injection: A Case Series Review.

To investigate cases of vitreous opacity (VO) similar to asteroid hyalosis (AH) after intravitreal brolucizumab injection. A retrospective chart review was conducted to identify cases showing VO similar to AH among patients who received intravitreal brolucizumab injections at our retinal clinic from January 2022 to January 2023. A total of 220 brolucizumab injections were administered at our hospital. VO, showing yellow-white brilliant reflective particles, was found in six patients (2.7%). When VO occurred, all patients complained of floaters, although none of them complained of other symptoms including decreased visual acuity, pain, or conjunctival redness. The mean number of brolucizumab injections was 2.57 ± 2.38. No significant visual impairment was observed while VO was present. VO improved in all cases, and four cases improved without any treatment. The mean interval from onset to disappearance of VO was 8.0 ± 3.1 weeks. VO, similar to AH, can occur with a relatively high probability after intravitreal brolucizumab injections. Patients complained of severe floaters, but VO was not accompanied by other symptoms including vision impairment, injection, and pain. The VO disappeared after approximately 4 to 14 weeks. In case that other inflammatory findings are not severe, close follow-up without treatment may be sufficient. If a patient complains of floaters after an intravitreal brolucizumab injection, close fundus observation is necessary to evaluate the VO.

Bilateral Ocular Leprosy An Effect By Erythema Nodusum Leprosum : A Case Report

Introduction : Leprosy or Hansen’s disease is an infection caused by Mycobacterium leprae that primarily affects the skin, the peripheral nerves and the eyes, causing chronic granulomatous inflammation.&#x0D; Case Illustration : We present a case of lepromatous leprosy with erythema nodosum leprosum of a 47 years old man with bilateral and asymmetrical ocular complications. One year ago patient consumed multidrug therapy for leprosy for one year but didn’t finish the medication. On the right eye diagnose with chronic anterior and intermediate uveitis, on the left eye with panuveitis. Best corrected visual acuity (BCVA) was 2/60 for right eye and light perception for left eye. Intraocular pressure were within normal limits. Madarosis and corneal hypoesthesia were found on both eyes. On the right eye was found cells, synechia anterior and posterior, iris pearls and vitreous haze. On the left eye was found plasmoid iridocyclitis and vitreous opacities from USG. Slit skin smear (SSS) result positif acid fast bacilli (AFB) dan granular. Patients were treated with multidrug therapy for leprosy, topical antibiotics, atropine and steroids, oral antibiotics and treatment from a dermatologist.&#x0D; Discussion : The diagnosis of lepromatous uveitis (LU) in this patient is made through skin tissue biopsy and ophthalmological examination. The effective management of ocular leprosy depends on early diagnosis and appropriate treatment. Hence it is imperative for ophthalmologist to recognize the ocular clinical signs associated with leprosy.&#x0D; Conclusion : Most blindness and impaired vision resulting from leprosy is preventable. A multidisciplinary approach is to be taken in order to improve the prognosis.

Diagnosis of Ocular Toxocariasis: a case report

Introduction : Ocular toxocariasis (OT) is an eye parasitosis due to incidental ingestion of Toxocara cati or canis larvae. Although mostly affects young children, it can also occur in older individuals. It is usually uniocular with various presentations.&#x0D; Case Illustration : A 69-year-old woman came with a chief complaint of deteriorating vision and pain in her left eye (LE)2 weeks prior to the visit, accompanied by floaters, redness, itchiness, and glare. She had a contact history with neighborhood dogs. Her best corrected visual acuity (VA) was 6/12 in the right eye (RE) and 3/60 in the LE. The intraocular pressure of LE was 27mmHg. Examinations of the LE found corneal edema, keratic precipitates, worm-like foreign bodies that moved in the anterior chamber, lens and vitreous opacity, and obscured fundus. The ultrasound showed a membrane-like lesion and no vitreomacular traction. The examination of the RE was unremarkable. We performed prompt foreign body extraction with local anesthesia and prescribed oral albendazole, topical and oral antibiotics, and steroids afterward. The investigation of the specimen revealed Toxocara larvae. There was no VA improvement after 1 month of close observation.&#x0D; Discussion : The OT diagnosis is based on clinical findings and a history of exposure to dogs or cats, soil, and consuming raw or undercooked meat. The gold standard for diagnosis is specimen biopsy. While no acceptable treatment regimen exists, the combination of anthelmintics and corticosteroids appears useful in some cases.&#x0D; Conclusion : Clinical presentation, parasitologic confirmation, and close contact with pets may be key elements to making the diagnosis.

Ocular Syphilis in an Immunocompetent Young Man

Introduction : Syphilis is called the great imitator because its clinical presentations vary widely and overlap with many other etiologies. We present a case of ocular syphilis in an immunocompetent young man with negative HIV test and history of unprotected sexual activities.&#x0D; Case Illustration : A 27 year-old male initially presented to an outpatient Solo Eye Hospital with complain of blurred vision and sudden visual impairment in the right eye and acute onset left eye redness, pain, clear discharge. His right eye VA was counting finger and 0,2 in his left eye. The patient diagnosed with acute posterior uveitis in the RE and acute iridocyclitis in the LE. A detailed sexual history, he endorsed having unprotected sex with numerous men in the past. Patient was subsequently started on P-Pred ED/2 hourly, atropine ED and testing to evaluate cause of iridocyclitis was sent. Fundus RE : clouded fundus view, vascular occlusion, vitreous opacification. Fundus LE : within normal limit. Rheumatoid factor negative, HIV antigen antibody screen non-reactive, syphilis IgG reactive, RPR screen reactive, RPR quantitative titer 1:128. ANA screen negative. The patient was started on intravenous penicillin G, and both his genital lesion and bilateral visual acuity improved. He was discharged to complete 14 fays of iv penicillin G.&#x0D; Discussion : HIV-positive patients may often present with ocular syphilis before the HIV status is known. Ocular syphilis is considered to be neurosyphilis for treatment purposes.&#x0D; Conclusion : Ocular syphilis should be kept in the differential diagnosis in immunocompetent/HIV negative patient, and the importance of obtaining a detailed sexual history should not be forgotten.

Ocular Syphilis in an Immunocompetent Young Man

Introduction : Syphilis is called the great imitator because its clinical presentations vary widely and overlap with many other etiologies. We present a case of ocular syphilis in an immunocompetent young man with negative HIV test and history of unprotected sexual activities.&#x0D; Case Illustration : A 27 year-old male initially presented to an outpatient Solo Eye Hospital with complain of blurred vision and sudden visual impairment in the right eye and acute onset left eye redness, pain, clear discharge. His right eye VA was counting finger and 0,2 in his left eye. The patient diagnosed with acute posterior uveitis in the RE and acute iridocyclitis in the LE. A detailed sexual history, he endorsed having unprotected sex with numerous men in the past. Patient was subsequently started on P-Pred ED/2 hourly, atropine ED and testing to evaluate cause of iridocyclitis was sent. Fundus RE : clouded fundus view, vascular occlusion, vitreous opacification. Fundus LE : within normal limit. Rheumatoid factor negative, HIV antigen antibody screen non-reactive, syphilis IgG reactive, RPR screen reactive, RPR quantitative titer 1:128. ANA screen negative. The patient was started on intravenous penicillin G, and both his genital lesion and bilateral visual acuity improved. He was discharged to complete 14 fays of iv penicillin G.&#x0D; Discussion : HIV-positive patients may often present with ocular syphilis before the HIV status is known. Ocular syphilis is considered to be neurosyphilis for treatment purposes.&#x0D; Conclusion : Ocular syphilis should be kept in the differential diagnosis in immunocompetent/HIV negative patient, and the importance of obtaining a detailed sexual history should not be forgotten.

Cataract Progression dan Lens Drop after Pars Plana Vitrectomy and Gas Tamponade : A Case Report

Introduction : Vitreous Hemorrhage (VH) in proliferative diabetic retinopathy (PDR) is common cause of acute vision loss.If the retina cannot be visualized and the etiology of the VH is unknown, pars plana vitrectomy (PPV) is indicated. 1Intraocular gases like SF6 or C3F8 are one of the most useful adjuncts in vitreoretinal surgery. Exposure to intraocular gases additionally increases retrolental oxygen levels, resulting in development of lens opacities.&#x0D; Case Illustration : Patient female 52 y.o, came with sudden blurry vision in the left eye since two weeks ago. History of Diabetes Mellitus 10 years with insulin treatment. From the examination left eye visual acuity 1/60, zonulysis, VH, and negative fundus reflect. On ultrasonography found vitreous opacity. The patient was diagnosed with left eye VH ec advanced PDR and scheduled PPV with C3F8 gas tamponade. Patient difficult to maintain prone position after surgery. 2 month after the surgery the patient scheduled with phacoemulsification surgery because progressive lens opacity. While prepare to the second operation, the lens found drop to the vitreous. The second surgery done with lens evacuation and Intraocular lens implantation. Last follow up, best correction visual acuity was 6/18.&#x0D; Discussion : PPV and Gas tamponade are presdisposing lens opacity progression. Lens opacity after gas tamponade include longer intraocular longevity gas and patients who fail to maintain a prone position. Risk factors for zonulysis in this patient increase the occurrence of lens drop after PPV with gas tamponade.&#x0D; Conclusion : Regular slit-lamp examination needs to be performed for early detection of cataract after PPV with gas tamponade.

Efficacy and safety of early YAG laser vitreolysis for symptomatic vitreous floaters: the study protocol for a randomized clinical trial

BackgroundVitreous floaters are a common ocular condition that affects individuals of all ages. Although vitreous floaters are typically benign, they can significantly impair visual acuity and quality of life. Laser vitreolysis, which uses an Nd: YAG laser to vaporize collagenous vitreous opacities, is increasingly being used as a treatment option. However, there is currently a lack of evidence regarding its efficacy and the appropriate timing of its application. This study aims to evaluate the efficacy and safety of early intervention with YAG laser vitreolysis in treating symptomatic vitreous floaters.MethodsThe present study is a randomized, controlled, double-blind clinical trial. A total of 70 participants with symptomatic floaters for 1 month were prospectively recruited. These participants will be randomly assigned to two groups, with 35 individuals in each group: the early treatment group and the delayed treatment group. Participants assigned to the early treatment group will undergo YAG laser vitreolysis immediately, followed by a sham laser treatment 3 months later. On the other hand, participants assigned to the delayed treatment group will receive a sham laser treatment and then undergo YAG laser vitreolysis 3 months later. The follow-up time points will be 1, 3, 6, and 12 months from randomization. Primary outcomes will be participants’ self-reported improvement in visual disturbance on a scale of 1 to 10 and their scores on the National Eye Institute Visual Functioning Questionnaire 25 (NEI VFQ-25). Secondary outcomes will be an objective evaluation of the effectiveness of the treatment in reducing vitreous floaters through OCT and fundus photography and tracking any adverse events related to the eyes or overall health.DiscussionThis clinical trial aims to evaluate the effectiveness of YAG laser vitreolysis in treating symptomatic vitreous floaters and assess the safety of performing early intervention with YAG laser vitreolysis.Trial registrationClinicalTrials.gov NCT05800353. Registered on 10 March 2023.

Occlusive retinal vasculitis as a presenting feature of primary vitreoretinal lymphoma relapse.

To report a case of primary vitreoretinal lymphoma (PVRL) relapse presenting as occlusive retinal vasculitis with secondary neovascularization. A retrospective case report. A Forty-year-old woman presented to the clinic with complaints of blurring of vision in the left eye for 4 months. Her best corrected visual acuity (BCVA) was 20/20 and 20/500 in the right and left eye, respectively. Both eyes' vitreous cavities showed vitreous opacities (2+). Both eyes fundus showed multifocal yellowish-white subretinal infiltration. A diagnostic vitreous and subretinal biopsy of the left eye revealed large lymphoid cells with CD20 positivity, confirming the diagnosis of PVRL. The patient received twelve intravitreal methotrexate (MTX) injections in both eyes over a course of 2 months, following which the lesions completely resolved. However, after 5 months, the left eye showed characteristic subretinal lesions along with perivascular exudates and retinal haemorrhages, diagnosed as PVRL relapse presenting as occlusive retinal vasculitis. Fluorescein angiography revealed retinal neovascularization (NVE), for which pan-retinal photocoagulation was performed along with repeated intravitreal MTX injection. PVRL is a great masquerader, and although rare, PVRL relapse can present as occlusive retinal vasculitis with secondary NVE, thereby delaying diagnosis and subsequent treatment.

Quantitative analysis of crystalline lens and vitreous opacities

Intraocular light scattering affects the contrast of the image created on the retina thus reducing the vision quality. Although one can consider the ocular components transparent, the microstructural changes (that are associated with aging or other factors) lead to the increase in intraocular light scattering. Therefore, the opacification of ocular structures is associated with vision‐affecting diseases such as corneal dystrophies, crystalline lens cataracts, vitreous floaters etc.Optical coherence tomography (OCT) is a non‐invasive imaging modality enabling generation of micrometre resolution, two‐dimensional (2‐D) cross‐sectional images and three‐dimensional (3‐D) volumetric data presenting internal structure of optically scattering tissues. OCT detects light that is back‐scattered/back‐reflected at the optical in homogeneities within the ocular structures. Due to its high sensitivity, OCT enables detection of ultralow scattered light levels obtained from weakly scattering tissues such as the vitreous body.In this talk, we will demonstrate in vivo enhanced three‐dimensional visualization of vitreous and lens opacities in normal subjects and cataract patients of different ages using a swept source OCT (SS‐OCT) system deployed to the Laboratory of Optics at the University of Murcia, Spain. The instrument operated at the central wavelength of 1050 nm and was optimized to image the anterior segment of the eye. Volumetric images were used to effectively map the opacities and to generate en‐face projection images of opacities.The results revealed the changes in the transparency of the crystalline lens showing lens micro‐ and macro‐scale features related to cataract such as cortical spokes, water clefts and enhanced scattering in the lens nucleus. On the other hand, vitreous imaging with SS‐OCT allowed for visualization of gel vitreous, liquefied lacunae, Berger's space, retrolental laminae and fibrous opacifications.Volumetric OCT data of the lens and retrolental vitreous were used to perform quantitative analysis of light scattering (transparency). We introduced indices describing transparency and optical homogeneity of ocular structures. Later on, we showed that those biomarkers correlate with age. Finally, statistical association between transparency of crystalline lens / vitreous and degradation of visual function was performed.The proposed imaging platform can be a new‐generation ophthalmic diagnostic tool in the fundamental studies as well as for objective clinical evaluation and management of eye diseases.

Vitreoretinal complications of uveitis: The role of vitrectomy

The scope of vitreoretinal intervention in patients with uveitis has recently expanded. Therapeutic vitrectomy is performed to address complications such as visual loss from vitreous opacities, retinal detachment, development of epiretinal membranes, hypotony and in certain cases to remove confined infective foci and assist in sustained drug delivery and diagnosis.While a plethora of studies report favourable outcomes of PPV in the management of uveitis, the quality of data remains poor, with a paucity of standardized reporting and limited prospective data.We will discuss our own experience and review the literature on each of the above surgical indications.

Application and visualization study of an intelligence-assisted classification model for common eye diseases using B-mode ultrasound images.

Conventional approaches to diagnosing common eye diseases using B-mode ultrasonography are labor-intensive and time-consuming, must requiring expert intervention for accuracy. This study aims to address these challenges by proposing an intelligence-assisted analysis five-classification model for diagnosing common eye diseases using B-mode ultrasound images. This research utilizes 2064 B-mode ultrasound images of the eye to train a novel model integrating artificial intelligence technology. The ConvNeXt-L model achieved outstanding performance with an accuracy rate of 84.3% and a Kappa value of 80.3%. Across five classifications (no obvious abnormality, vitreous opacity, posterior vitreous detachment, retinal detachment, and choroidal detachment), the model demonstrated sensitivity values of 93.2%, 67.6%, 86.1%, 89.4%, and 81.4%, respectively, and specificity values ranging from 94.6% to 98.1%. F1 scores ranged from 71% to 92%, while AUC values ranged from 89.7% to 97.8%. Among various models compared, the ConvNeXt-L model exhibited superior performance. It effectively categorizes and visualizes pathological changes, providing essential assisted information for ophthalmologists and enhancing diagnostic accuracy and efficiency.