Posterior Vitreous Detachment in Highly Myopic Eyes Undergoing Vitrectomy

Philippakis, Elise; Couturier, Aude; Gaucher, David; Gualino, Vincent; Massin, Pascale; Gaudric, Alain; Tadayoni, Ramin

doi:10.1097/iae.0000000000000857

Cited by 19 publications

(8 citation statements)

References 28 publications

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“…PVD can be visualised with the help of optical coherence tomography (OCT) 2014. It can be partial or complete; a partial PVD may appear as paramacular, perifoveal or vitreo‐foveal separation, whereas a complete PVD may appear as a detached posterior vitreous with a Weiss ring (ring‐shaped floater) 2014…”

Section: Vitreousmentioning

confidence: 99%

“…Visual acuity may not be affected in partial or complete PVDs; however, a moderate visual impairment was reported in high myopic adults with PVD and co‐existing pathologies (Snellen 6/36 or seven‐line loss) 2016. PVD alone may not require any treatment but would require vitreoretinal surgery (vitrectomy) if co‐existing with retinal detachment or epiretinal membrane (detailed in sections below).…”

Section: Vitreousmentioning

confidence: 99%

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Posterior segment conditions associated with myopia and high myopia

Jagadeesh

Philip

Fedtke

et al. 2020

Clinical and Experimental Optometry

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Myopia, and especially high myopia, is associated with a number of posterior segment changes that are considered to be mostly a consequence of the increased axial elongation. This can result in mechanical strain, attendant vascular changes, stretching and thinning of tissues, and atrophy/deformation of tissues in later or more advanced stages. Such myopiarelated changes are observed as changes and/or abnormalities in the vitreous, choroid, retina and peripheral retina, sclera and/or optic disc. Although many of these changes are benign, at times they may be associated with significant vision impairment that either requires active intervention or may suggest future progression of the disease. This review systematically addresses the posterior segment conditions seen in myopic eyes, describes the features associated with the condition and details management pathways.

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Section: Vitreousmentioning

confidence: 99%

Section: Vitreousmentioning

confidence: 99%

Posterior segment conditions associated with myopia and high myopia

Jagadeesh

Philip

Fedtke

et al. 2020

Clinical and Experimental Optometry

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“…The standard instruments may be too short to reach the posterior pole 49. The residual vitreous cortex may be attached to the retina even in eyes with apparent complete PVD 50. The thin vitreous cortex is difficult to remove completely, and might be related to recurrence and development of PVR.…”

Section: Introductionmentioning

confidence: 99%

Scleral buckling in the management of rhegmatogenous retinal detachment: patient selection and perspectives

Park¹,

Lee²,

Lee³

2018

OPTH

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Although the technique of pars plana vitrectomy (PPV) develops rapidly, scleral buckling (SB) has several advantages over PPV for rhegmatogenous retinal detachment (RRD), including early visual rehabilitation and prevention of cataract progression. It is recommended to select the primary procedure for RRD by considering the advantages and disadvantages of each procedure based on the patient status. The vitreous body status affects the features of RRD. Vitreous liquefaction is an age-dependent process, resulting in the development of posterior vitreous detachment (PVD). RRD is usually associated with PVD, typically presenting with a retinal tear, strong vitreoretinal traction, and bullous detachment. In contrast, RRD may develop without PVD, and typically presents with a small atrophic hole, shallow detachment, and slow progression. RRD with less liquefied vitreous and no PVD can be managed successfully with SB alone even in the presence of subretinal strand as less liquefied vitreous acts as bio-tamponade blocking fluid passage. The strong traction induced by PVD and bullous detachment in an eye with extensively liquefied vitreous reduces the success rate of SB. PPV is gaining popularity as the primary procedure for RRD, especially in eyes with retinal tears, PVD, or pseudophakia. Nevertheless, SB remains the preferred procedure in young phakic patients without PVD.

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“…Presence of PVD in high myopia is approximately 50% in eyes undergoing vitrectomy, with less than 15% PVD in eyes having myopic foveoschisis 27. This emphasises the need for complete PVD induction in eyes with MMHRD.…”

Section: Discussionmentioning

confidence: 98%

Utility of microscope-integrated optical coherence tomography (MIOCT) in the treatment of myopic macular hole retinal detachment

Kumar

Kakkar²,

Ravani

et al. 2017

BMJ Case Reports

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Macular hole-associated retinal detachment in high myopia is described as a final stage in progression of myopic traction maculopathy (MTM). Shimada described the progressive stages of MTM from macular retinoschisis to serous retinal detachment in high myopia. Stage 4 MTM is characterised as disappearance of retinoschisis with progression to retinal detachment due to macular hole formation. It is hypothesised that vitreoschisis and abnormal vitreo-retinal interface create the premacular tangential traction. Intraoperative triamcinolone acetonide is used to visualise the residual posterior vitreous cortex (PVC). We hereby describe the utility of microscope-integrated optical coherence tomography (MIOCT) in assisting complete removal of PVC and internal limiting membrane (ILM) peeling with multilayered inverted ILM flap in the treatment of myopic macular hole retinal detachment. MIOCT helped identify vitreoschisis and confirm the position of ILM flaps over the macular hole intraoperatively.

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Posterior Vitreous Detachment in Highly Myopic Eyes Undergoing Vitrectomy

Cited by 19 publications

References 28 publications

Posterior segment conditions associated with myopia and high myopia

Posterior segment conditions associated with myopia and high myopia

Scleral buckling in the management of rhegmatogenous retinal detachment: patient selection and perspectives

Utility of microscope-integrated optical coherence tomography (MIOCT) in the treatment of myopic macular hole retinal detachment

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