Häufigkeit einer hinteren Glaskörperabhebung bei Augen mit und ohne altersabhängiger Makuladegeneration Eine echographische Studie * (Incidence of posterior vitreous detachment in eyes with and without age-related macular degeneration: an ultrasound study)

1996 ◽  
Vol 93 (6) ◽  
pp. 660-665 ◽  
Author(s):  
Brigitte Weber-Krause ◽  
Ute Eckardt
Keyword(s):  
Macular Degeneration ◽  
Posterior Vitreous Detachment ◽  
Age Related Macular Degeneration ◽  
Vitreous Detachment ◽  
Age Related ◽  
Ultrasound Study

Effect of posterior vitreous detachment on treat-and-extend versus monthly ranibizumab for neovascular age-related macular degeneration

2019 ◽  
Vol 104 (7) ◽  
pp. 899-903 ◽  
Author(s):  
Sebastian M Waldstein ◽  
Leonard Coulibaly ◽  
Sophie Riedl ◽  
Amir Sadeghipour ◽  
Bianca S Gerendas ◽  
...  
Keyword(s):  
Macular Degeneration ◽  
Posterior Vitreous Detachment ◽  
Median Number ◽  
Age Related Macular Degeneration ◽  
Controlled Clinical Trial ◽  
Vitreous Detachment ◽  
Treat And Extend ◽  
Age Related ◽  
Treatment Naïve ◽  
The Impact

AimsTo investigate the impact of posterior vitreous detachment (PVD) on the efficacy of treat-and-extend (T&E) ranibizumab in neovascular age-related macular degeneration.MethodsIn a post hoc analysis of a randomised controlled clinical trial, spectral-domain optical coherence tomography images of treatment-naïve patients randomised to receive T&E (n=265) or monthly (n=264) ranibizumab for 12 months were included. Certified, masked graders diagnosed the presence or the absence of complete PVD. The main outcome measures were the mean change in best-corrected visual acuity (BCVA) and central retinal thickness (CRT) at month 12, the number of administered ranibizumab injections and the proportion of patients extended to more than 8 weeks.ResultsAt baseline, complete PVD was present in 51% and 56% of patients in the monthly and T&E arms, respectively. Mean change in BCVA at month 12 was +9.0 (PVD) vs +9.5 letters (no PVD, p=0.78) in monthly treated eyes, and +6.0 (PVD) vs +7.5 letters (no PVD, p=0.42) in T&E treated eyes. Conversely, mean change in CRT at month 12 was −174 (PVD) vs −173 µm (no PVD, p=0.98) in the monthly arm, and −175 (PVD) vs −164 µm (no PVD, p=0.58) in the T&E arm. In T&E treated patients, the median number of injections was eight vs nine (p=0.035). 71% of PVD eyes were extended successfully, compared with 55% of eyes without PVD (p=0.005).ConclusionPVD was not found to impact functional and anatomical outcomes of T&E ranibizumab therapy. However, patients without a complete PVD required more retreatments and were significantly less likely to be successfully extended.Trial registration numberNCT01948830

scholarly journals The influence of vitreomacular adhesion on the pathogenesis and course of age-related macular degeneration

2013 ◽  
Vol 6 (1) ◽  
pp. 53-60
Author(s):  
Nikita Yuryevich Dal ◽  
Gassan Basharovich Shaar ◽  
Yuriy Sergeyevich Astakhov ◽  
Marina Mikhaylovna Lobanova
Keyword(s):  
Macular Degeneration ◽  
Posterior Vitreous Detachment ◽  
Age Related Macular Degeneration ◽  
Vitreomacular Adhesion ◽  
Vitreous Detachment ◽  
Age Related ◽  
Different Types ◽  
Age Related Changes

This article describes the age-related changes in vitreous and different types of posterior vitreous detachment. Possible effect of normal and pathological posterior vitreous detachment (in particular vitreomacular adhesion and traction syndrome) on the age-related macular degeneration course are considered. Vitrectomy and pharmacological vitreolysis potentials in the treatment of vitreomacular adhesion are discussed.

Diagnosing and Treating Vitreomacular Adhesion

2011 ◽  
Vol 05 (01) ◽  
pp. 69 ◽  
Author(s):  
Paolo Carpineto ◽  
Luca Di Antonio ◽  
Agbeanda Aharrh-Gnama ◽  
Vincenzo Ciciarelli ◽  
Leonardo Mastropasqua ◽  
...  
Keyword(s):  
Posterior Vitreous Detachment ◽  
Standard Of Care ◽  
Age Related Macular Degeneration ◽  
Vitreomacular Traction ◽  
Vitreous Surgery ◽  
Vitreomacular Adhesion ◽  
Current Standard ◽  
Vitreous Detachment ◽  
Age Related ◽  
23 Gauge

Perifoveal vitreous detachment with residual vitreofoveal adhesion is considered as the first stage of posterior vitreous detachment. A key point is the transition from an innocuous vitreomacular adhesion (VMA) to a pathological vitreomacular traction (VMT). By using optical coherence tomography (OCT), VMA is defined as adhesion of the posterior hyaloid cortex involving the centre of the foveal region with or without a hyper-reflective signal on the inner surface of the retina. VMT is diagnosed when the inner macular surface slopes steeply, or sharp angulation and localised deformation of the retinal profile is detected at the VMA site. Otherwise, VMA is simply considered to be persistent adherence of the cortical vitreous. The tractional effects of perifoveal vitreous detachment cause a variety of macular pathologies determined by the size and the strength of the residual vitreoretinal adhesion. Vitreomacular adhesion plays a major role in the development of diseases such as vitreomacular traction syndrome (VMTS), macular hole, epiretinal membrane, tractional macular oedema and myopic macular retinoschisis. In addition, clinical evidence supports the theory that the course of diabetic retinopathy and age-related macular degeneration may be strongly influenced by an incomplete posterior vitreous separation. The current standard of care of vitreomacular interface pathologies is vitrectomy and membrane peeling – a procedure that is thought to relieve epiretinal traction – followed by regeneration of the retinal architecture and recovery of visual function. Over the last few years, with the introduction of 25-gauge (0.50mm) and 23-gauge (0.72mm) instruments, there has been another major shift toward transconjunctival microincisional vitrectomy surgery (MIVS). Pharmacological induction of posterior vitreous detachment (PVD) can become a further step toward a real ‘minimally invasive vitreous surgery’ for VMTS.

scholarly journals Vitreomacular Adhesion, Vitreomacular Traction, and Concurrent Diseases

2018 ◽  
pp. 256-261
Keyword(s):  
Posterior Vitreous Detachment ◽  
Age Related Macular Degeneration ◽  
Optic Coherence Tomography ◽  
Retinal Diseases ◽  
Vitreomacular Adhesion ◽  
Vitreous Detachment ◽  
Age Related ◽  
Vitreomacular Interface ◽  
Vascular Occlusions ◽  
Endothelial Growth Factor

The introduction of the optic coherence tomography in ophthalmology has been enabled us to understand the relationship between vitreomacular interface pathologies and concurrent retinal diseases. It is known that vitreomacular adhesion (VMA) and traction (VMT) develops as a result of an incomplete posterior vitreous detachment. VMA/VMT usually coincidence with age-related macular degeneration, diabetic macular edema, and retinal vascular occlusions. Some studies suggested that the complete posterior vitreous detachment is protective against these kinds of retinal diseases. It is proclaimed that VMA/VMT may have a role in the etiology and progression of these retinal diseases. And also, in the majority of the studies, it is proposed that VMA/VMT may interfere with the treatment and even worsen the result of the anti-vascular endothelial growth factor (Anti-VEGF) therapy which is used within the treatment regime of these retinal diseases. It is obvious that further studies are needed to clarify the cause-result relationship and the effectiveness of the treatment for the concurrent retinal diseases.

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