This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on ISI (30)  • Contact me when this article is cited  Related Content  • Related article  • Similar articles in this journal  Topic Collections  • Articles for Residents  • Vitreous Disorders  • Aging/ Geriatrics  • Alert me on articles by topic

Eisuke Uchino, MD; Akinori Uemura, MD; Norio Ohba, MD, PhD

Arch Ophthalmol. 2001;119:1475-1479.

Objective  To promote understanding of the development of posterior vitreous detachment (PVD) in healthy eyes using optical coherence tomography (OCT).

Methods  We studied 209 eyes of 209 healthy volunteers (165 men and 44 women; mean age, 52.3 years [range, 31-74 years]). In addition to biomicroscopy and ophthalmoscopy, OCT was performed to obtain high-resolution cross-sectional images of the vitreoretinal interface in the posterior fundus.

Results  The condition of the posterior vitreoretinal interface was classified as 1 of 5 stages, according to biomicroscopic findings and OCT images relative to discrete linear signals indicating a detached posterior vitreous face: stage 0, no PVD (61 eyes [29.2%]); stage 1, incomplete perifoveal PVD in up to 3 quadrants (100 eyes [47.8%]); stage 2, incomplete perifoveal PVD in all quadrants, with residual attachment to the fovea and optic disc (26 eyes [12.4%]); stage 3, incomplete PVD over the posterior pole, with residual attachment to the optic disc (4 eyes [1.9%]); or stage 4, complete PVD identified with biomicroscopy, but not with OCT because of instrument limitations (18 eyes [8.6%]). Stage 1, 2, and 3 incomplete PVD without subjective symptoms was not recognizable on contact lens biomicroscopy. There was a significant age-related progression in the condition of the vitreoretinal interface from stage 0 to stage 4. The superior quadrant was usually the initial site of incomplete PVD.

Conclusions  Optical coherence tomography demonstrates that healthy human eyes have incomplete or partial PVD beginning as early as the fourth decade of life. Age-related PVD occurs initially as a focal detachment in the perifovea of 1 quadrant, with persistent attachment to the fovea and optic nerve head, with a predilection for the superior quadrant. It extends its range slowly for years and eventually results in complete PVD, associated with release of vitreopapillary adhesion.

From the Department of Ophthalmology, Kagoshima University Faculty of Medicine, Kagoshima, Japan.

RELATED ARTICLE

Archives of Ophthalmology Reader's Choice: Continuing Medical Education
Arch Ophthalmol. 2001;119(10):1569-1570.
FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Results of surgery on macular holes that develop after rhegmatogenous retinal detachment
Benzerroug et al.
Br. J. Ophthalmol. 2008;92:217-219.
ABSTRACT | FULL TEXT  

Optical coherence tomography of the vitreomacular interface in photodynamic therapy
Witkin et al.
Br. J. Ophthalmol. 2005;89:929-929.
FULL TEXT  

Late onset of rhegmatogenous retinal detachments after successful posterior segment intraocular foreign body removal
Weissgold and Kaushal
Br. J. Ophthalmol. 2005;89:327-331.
ABSTRACT | FULL TEXT  

Optic Disc Traction Syndrome Associated With Central Retinal Vein Occlusion
Rumelt et al.
Arch Ophthalmol 2003;121:1093-1097.
ABSTRACT | FULL TEXT  

Optical coherence tomography of superior segmental optic hypoplasia
Unoki et al.
Br. J. Ophthalmol. 2002;86:910-914.
ABSTRACT | FULL TEXT