The Vitreous, the Retinal Interface in Ocular Health and Disease

Abstract

The vitreous is a complex structure whose composition and appearance change with age. Anomalous adhesions between the posterior vitreous face and the retinal surface are the cause of numerous vitreoretinal complications, while the presence of an intact posterior hyaloid provides a scaffold for vascular growth and anteroposterior traction. This review summarizes what is known about the biochemistry of the vitreous, the process of posterior vitreous detachment (PVD) development, and the available clinical approaches to examining the vitreous and its interface. A pooled analysis of studies looking at the presence of a complete, partial or absent PVD in a number of macular and retinal diseases allows us to establish odds ratios for these various states. From this emerge both protective and disease-associated states in conditions such as proliferative diabetic retinopathy, macular edema, and age-related macular degeneration. With the emergence of pharmacological means to separate the posterior hyaloid, a better understanding of the possible role of the vitreous in tractional syndromes is required.

Deregulation of ocular nucleotide homeostasis in patients with diabetic retinopathy

“…Given that the VF represents the largest structure within the eye occupying about 80 % of the ocular volume [44], soluble enzymes could comprise an important auxiliary effector system for tuned regulation of nucleotide concentrations in the eye. For instance, large surface-to-volume ratio of the retina may facilitate diffusion of soluble eN/CD73 and its metabolite adenosine from the vitreous core to the vitreoretinal interface, thereby contributing to the known phenomenon of relative tolerance and functional Fig.…”

The Disease Course of Bilateral Endogenous Fungal Endophthalmitis

“…The presence of an intact interface or posterior hyaloid provides a scaffold for vascular growth and anteroposterior traction; moreover, anomalous adhesions between the posterior vitreous face and the retinal surface can cause numerous vitreoretinal complications such as proliferative diabetic retinopathy and macular edema [11]. Although no reports have been published examining the relationship between the interface and EFE, we suspect that the probable mechanism, which is based on experimental studies of endogenous Candida endophthalmitis in rabbits, is as follows [12].…”

Gesunder Glaskörper und seine Alterung

“…3), an der der Glaskör-per besonders fest mit der Netzhaut verbunden ist. Der hintere Glaskörperkor-tex weist die zweithöchste Kollagenkonzentration auf [4]. Das Kollagen Typ II des Glaskörpers ist zwar nicht ganz identisch mit dem Knorpelkollagen, aber doch sehr ähnlich.…”

“…Hierbei kommt es zu einer Spaltung des posterioren Glaskörperkor-tex in 2 Schichten, die bei verschiedenen Erkrankungen der vitreoretinalen Grenzfläche von Bedeutung ist [14,17,18]. Selten kann es auch zu einer gemeinsamen Ablösung der ILM und der posterioren Glaskörperrinde kommen -etwa nach Trauma [4]. …”