Imaging the Vitreous With a Novel Boosted Optical Coherence Tomography Technique

Abstract

Purpose: To evaluate the degenerative findings including cistern formation in the premacular vitreous using optical coherence tomography.Methods: A novel enhanced vitreous imaging method by which four A-scans at each position were averaged before the Fourier transform increased the image quality per frame so that subsequent image registration for averaging could occur. Analysis of B-scans and volume-rendered images of eyes in subjects of various ages was performed.Results: There were 43 eyes of 23 subjects ranging in age from 23 to 68 years. The texture in the vitreous images suggests specific orientations of the vitreous fibers in the macular region; there were fibers circumferential to the retina immediately anterior to the premacular bursa. The pattern of the vitreous fibers seemed less well-defined internal to the zone of circumferential fibers. In younger eyes, there were striations oriented in a roughly inferior to superior direction in this zone. In older eyes, there were striations in the same orientation but actually were alternating zones of vitreous synchysis and syneresis. In these same eyes, numerous cisterns appeared at various levels in the vitreous gel. With extensive vitreous condensation and synchysis, definition of the premacular bursa was lost.Conclusion: With this novel method of enhanced vitreous imaging, the vitreous seemed to have stereotypic patterns of degeneration. The formation of vitreous syneresis and synchysis may be related to organization architecture of the vitreous, including the pattern of vitreous collagen deposition, and the effects of eye motion through decades of time.

The Way Patients See Floaters

“…14,15 Type II collagen spontaneously aggregates with other collagen fibrils because of mutual attraction to form collagen fibers. 14,15 Excessive aggregation of Type II collagen is prevented by Type IX collagen, which sequesters Type II collagen into inner fibers when hybrid fibrils between Types II and IX collagen are made. 14,15 As one ages, there is exponential loss of Type IX collagen, which leads to exposure of sequestered Type II collagen and spontaneous aggregation of Type II collagen fibrils.…”

“…14,15 Excessive aggregation of Type II collagen is prevented by Type IX collagen, which sequesters Type II collagen into inner fibers when hybrid fibrils between Types II and IX collagen are made. 14,15 As one ages, there is exponential loss of Type IX collagen, which leads to exposure of sequestered Type II collagen and spontaneous aggregation of Type II collagen fibrils. 14,15 Vitreous cisterns also form when pockets of liquid vitreous result from the collection of solubilized hyaluronan and its associated water molecules 14,15 (Figure 4).…”

“…The framework and structural strength of vitreous is provided by collagen fibrils, which largely consist of Type II collagen. 14,15 Type II collagen spontaneously aggregates with other collagen fibrils because of mutual attraction to form collagen fibers. 14,15 Excessive aggregation of Type II collagen is prevented by Type IX collagen, which sequesters Type II collagen into inner fibers when hybrid fibrils between Types II and IX collagen are made.…”

Correspondence

“…In recent years, novel 3D OCT data and perspectives on both the vitreous body and vitreoretinal interface have been documented. 11,14–16…”

“…In recent years, novel 3D OCT data and perspectives on both the vitreous body and vitreoretinal interface have been documented. 11,[14][15][16] Regarding possible detection of the posterior hyaloid in the central B-scan image, or not, in a case of i-PVD and extrafoveal vitreous contact, it would depend on 1) both the distance and angle of the vitreoretinal or vitreopapillary contact site from the fovea and 2) the height of the vitreous from the fovea by the OCT image: The wider OCT field, the higher the distance of the vitreous body from the fovea. At a 6 • 6-mm scanning, as shown in the last two images (middle and bottom scans) in Figure 1 of the current article, 1 one can find out that the vitreous height in each is less than 1 mm.…”