Purpose

Posterior vitreous detachment (PVD) plays an important role in vitreoretinal interface disorders. Historically, observations of PVD using OCT have been limited to the macular region. The purpose of this study is to image the wide-angle vitreoretinal interface after PVD in normal subjects using montaged OCT images.

Design

An observational cross-sectional study.

Participants

A total of 144 healthy eyes of 98 normal subjects aged 21 to 95 years (51.4±22.0 [mean ± standard deviation]).

Methods

Montaged images of horizontal and vertical OCT scans through the fovea were obtained in each subject.

Main Outcome Measures

Montaged OCT images.

Results

By using wide-angle OCT, we imaged the vitreoretinal interface from the macula to the periphery. PVD was classified into 5 stages: stage 0, no PVD (2 eyes, both aged 21 years); stage 1, peripheral PVD limited to paramacular to peripheral zones (88 eyes, mean age 38.9±16.2 years, mean ± standard deviation); stage 2, perifoveal PVD extending to the periphery (12 eyes, mean age 67.9±8.4 years); stage 3, peripapillary PVD with persistent vitreopapillary adhesion alone (7 eyes, mean age 70.9±11.9 years); stage 4, complete PVD (35 eyes, mean age 75.1±10.1 years). All stage 1 PVDs (100%) were observed in the paramacular to peripheral region where the vitreous gel adheres directly to the cortical vitreous and retinal surface. After progression to stage 2 PVD, the area of PVD extends posteriorly to the perifovea and anteriorly to the periphery. Vitreoschisis was observed in 41.2% at PVD initiation (stage 1a).

Conclusions

Whereas prior work suggests that PVD originates in the perifoveal region and after the sixth decade, our observations demonstrate that (1) PVD first appears even in the third decade of life and gradually appears more extensively throughout life; (2) more than 40% of eyes without fundus diseases at their PVD initiation are associated with vitreoschisis; and (3) PVD is first noted primarily in the paramacular-peripheral region where vitreous gel adheres to the retinal surface and is noted to be more extensive in older ages to ultimately involve the fovea.

中文翻译：

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广角OCT成像观察到玻璃体后脱离

目的

玻璃体后脱离（PVD）在玻璃体视网膜界面疾病中起重要作用。从历史上看，使用OCT进行PVD的观察仅限于黄斑区域。这项研究的目的是使用蒙太奇的OCT图像对正常受试者PVD后的广角玻璃体视网膜界面进行成像。

设计

观察性横断面研究。

参加者

98名年龄在21至95岁之间的正常受试者的144眼健康眼睛（51.4±22.0 [平均值±标准差]）。

方法

在每个对象中获得通过中央凹的水平和垂直OCT扫描的蒙太奇图像。

主要观察指标

蒙太奇的OCT图像。

结果

通过使用广角OCT，我们成像了从黄斑到周围的玻璃体视网膜界面。PVD分为5个阶段：第0阶段，无PVD（2眼，均年龄21岁）；第1阶段，外周PVD限于黄斑部至外周区（88眼，平均年龄38.9±16.2岁，平均±标准差）；第二阶段，小凹PVD延伸至周围（12只眼，平均年龄67.9±8.4岁）；第三阶段，仅伴持续性玻璃体乳头粘连的乳头状旁周PVD（7只眼，平均年龄70.9±11.9岁）；第4阶段，完整的PVD（35眼，平均年龄75.1±10.1岁）。在玻璃体凝胶直接粘附至皮质玻璃体和视网膜表面的黄斑旁至周围区域中观察到所有第一阶段PVD（100％）。在发展到第2阶段PVD之后，PVD的区域向后延伸至中央凹，而向后延伸至周围。

结论

先前的研究表明，PVD起源于中央凹区和第六个十年之后，但我们的观察结果表明：（1）PVD甚至在生命的第三个十年中首次出现，并在整个生命中逐渐广泛地出现；（2）超过40％的未患有眼底疾病的眼睛在开始PVD时与玻璃体劈裂有关；（3）PVD首先主要出现在玻璃体凝胶粘附到视网膜表面的黄斑旁周围区域，并且在老年人中发现更广泛，最终累及中央凹。