Increased internal higher-order aberrations as a useful parameter for indication of vitrectomy in three asteroid hyalosis cases

Abstract

SUMMARYWe report three asteroid hyalosis cases in which internal higher-order aberrations (HOAs) were improved concomitant with improved visual symptoms after vitrectomy. Cases 1 and 2 reported severe floaters and glare disability, although their visual acuities were fairly good. Case 3 showed poor visual acuity since this patient also suffered from mild macular degeneration. For these three asteroid hyalosis cases, we were unsure if treatment with vitrectomy could improve visual symptoms. Therefore, we measured internal HOAs with an aberrometer, and found that the internal HOA values in these cases were high. We suspected that internal high HOAs values were associated with visual disturbance, and performed vitrectomy. After the vitrectomy, the internal HOA values in these three asteroid hyalosis cases markedly decreased, and visual symptoms improved. These observations suggested that measurement of internal HOAs may be useful to determine the indication for vitrectomy. BACKGROUND

Spotlight on Asteroid Hyalosis: A Clinical Perspective

“…All complained of glare and floaters and their eyes with asteroid hyalosis were measured to high level of internal higher-order aberrations. 40 Vitrectomy decreased the internal higherorder aberrations and relieved the patients of their visual symptoms. 40 In a study of two cases, Sato et al reported on the use of the internal higher-order aberrations for treatment decision.…”

“…40 Vitrectomy decreased the internal higherorder aberrations and relieved the patients of their visual symptoms. 40 In a study of two cases, Sato et al reported on the use of the internal higher-order aberrations for treatment decision. 41 In one case, the clinical examination revealed mild cataract and asteroid hyalosis in one eye, and only cataract in the other eye.…”

Asteroid Hyalosis: An Update on Prevalence, Risk Factors, Emerging Clinical Impact and Management Strategies

“… 39 , 41 Higher order aberrations can be a source of visually symptomatic AH and use of an aberrometer to quantify these aberrations in correlation with patient-reported symptoms can provide an objective data point to assist with the decision to pursue surgery for symptomatic AH. 42 , 43 …”

“…39,41 Higher order aberrations can be a source of visually symptomatic AH and use of an aberrometer to quantify these aberrations in correlation with patient-reported symptoms can provide an objective data point to assist with the decision to pursue surgery for symptomatic AH. 42,43 Specific outcomes data for surgical treatment of AH are limited due to the rarity of these cases. To our knowledge, the only case series of patients undergoing vitrectomy for visually symptomatic AH, without additional retinal pathology, was reported in 1998 by Parnes et al, 44 who found at least neline of Snellen visual acuity improvement in nine of ten total eyes.…”