Vitreous pp 241-263 | Cite as

III.B. Anomalous Posterior Vitreous Detachment and Vitreoschisis

Chapter
First Online:

Abstract

Alterations in the molecular composition, organization, and structure of the human vitreous are an inevitable consequence of aging. Complete and innocuous posterior vitreous detachment (PVD) is the most common ultimate consequence of vitreous aging [see chapter II.C. Vitreous aging and PVD], but this can often be disturbed by anomalies in this complex process. Insufficient dehiscence at the vitreoretinal interface, excessive gel liquefaction, or both can result in an anomalous PVD (APVD), sometimes associated with vitreoschisis (VS), which is a lamellar split in the posterior vitreous cortex. APVD and VS are associated with different clinical pathologies. A detailed analysis of vitreous pathophysiology that leads to APVD and VS will enable a better understanding of vitreoretinal disease pathogenesis, improve diagnostic acumen, and provide new directions for therapeutic approaches that will ultimately lead to effective preventative strategies.

Keywords

Vitreous Vitreoretinal interface Hyalocytes Aging Liquefaction Vitreoretinal dehiscence Posterior vitreous detachment (PVD) Anomalous PVD Vitreomacular traction Vitreo-papillary adhesion Vitreoschisis Macular hole Macular pucker 
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Supplementary material

305359_1_En_14_MOESM1_ESM.mp4 (12.1 mb)
Video III.B-1 Multifocal Vitreomacular Traction (VMT). Due to anomalous posterior vitreous detachment, the full-thickness posterior vitreous cortex does not separate from the retina and pulls anteriorly. Three separate foci of vitreoretinal traction can be identified, the largest at the macula. Vitreomacular traction is so severe that the macula is considerably elevated disturbing central vision (Courtesy of Carl Glittenberg, MD, and Prof Susanne Binder). (AVI 131278 kb)

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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • J. Sebag
    • 1
    • 2
  • Moritz Niemeyer
    • 1
    • 2
  • Michael J. Koss
    • 3
    • 2
  1. 1.VMR Institute for Vitreous Macula RetinaHuntington BeachUSA
  2. 2.Doheny Eye InstituteLos AngelesUSA
  3. 3.Department of OphthalmologyRupprecht Karls UniversityHeidelbergGermany

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