Masataka Takahashi

Role of the Vitreous in Idiopathic Preretinal Macular Fibrosis

Of 250 eyes with idiopathic preretinal macular fibrosis, 56 had no posterior vitreous detachment (Group 1), ten had partial posterior vitreous detachments without vitreous traction to the macula (Group 2), 29 had partial posterior vitreous detachments with vitreous traction to the macula (Group 3), and 155 had complete posterior vitreous detachments (Group 4). There were significantly more eyes with visual acuities of 20/60 or worse, cystoid macular changes, or macular fluorescein leakage in Group 3 than in Group 1 or Group 4. Thus, the presence of vitreous traction to the macula was associated with worse anatomic and functional findings.

Role of the Vitreous in Diabetic Retinopathy: I. Vitreous Changes in Diabetic Retinopathy and in Physiologic Aging

The vitreoretinal relationships in 1021 eyes of 570 patients with diabetic retinopathy and in 857 normal eyes were studied retrospectively in an attempt to identify the vitreous changes specifically related to diabetes. Complete posterior vitreous detachment (PVD) occurred in diabetic patients largely as part of the aging process, but proliferation interfered with its development. Complete PVD with nonproliferative diabetic retinopathy in the younger age groups was more prevalent in eyes treated by panretinal photocoagulation (PRP) than in untreated eyes and thus might have an association with PRP treatment. Partial PVD, seen mainly in proliferative diabetic retinopathy, had no correlation with aging. In the eyes of patients who were younger when diabetes was diagnosed, the development of partial PVD had a close correlation with the duration of diabetes. The data suggest the need for a clinical trial of early photocoagulation, before partial PVD develops, in younger-onset diabetic patients showing early proliferative changes.

Vitreous changes in retinal branch vein occlusion.

The vitreous was studied in 50 eyes with retinal branch vein occlusion (RBVO) and compared to an age-matched control group. The incidence of partial vitreous detachment was significantly higher (22%) in the RBVO group than in the control group (2.2%) (P less than 0.01). The incidence of preretinal neovascularization in the RBVO group was 22%. No new vessels formed in eyes with complete posterior vitreous detachment (P less than 0.05). The risk of vitreous hemorrhage was greatest in patients with partial vitreous detachment (64%). There was no significant correlation between the status of the vitreoretinal relationship and the development of macular edema, which occurred in 56% of the patients. In two patients, intermittent vitreous traction on the fovea may have influenced the evolution of chronic macular edema and lamellar hole formation. Vascular occlusive disease of the retina produces significant changes in the overlying vitreous. These vitreous changes in turn influence the development of complications following retinal vascular occlusions.

Vitreous Cinematography in the Study of Vitreoretinal Diseases

A new technique of vitreous cinematography involves scanning of the vitreous cavity using optical sections to provide objective, reproducible information on the dynamics of the posterior vitreous and vitreoretinal relationships. Using a newly developed preset lens (El Bayadi-Kajiura lens), this technique makes it possible to document an entire optical section of the posterior vitreous. This is done by mechanically displacing the vitreous so that maximum reflectivity can be obtained from the vitreous gel. This article describes the technique and presents clinical examples documenting complete and incomplete vitreous detachment in normal eyes, Cloquets canal associated with an optic disc pit, vitreous traction associated with a lamellar hole in an area of preretinal macular fibrosis, and vitreous traction at the anterior flap of a retinal break.

Atlas of vitreous biomicroscopy

The Importance and History of Vitreous Biomicroscopy Examination of the Patient Preparation for the Examination Documentation of Vitreous Examination Examination Technique of Vitreous Biomicroscopy Pathological Conditions of the Vitreous Degenerative Changes of the Vitreous Body Opacities in the Vitreous Cavity Vascular Diseases Retinal Breaks Uveitis Macular Diseases Tumors