title: Evaluation of a posterior vitreous detachment: a comparison of biomicroscopy, B-scan ultrasonography and optical coherence tomography to surgical findings with chromodissection.
abstract: OBJECTIVE
  To find the most reliable and efficient noninvasive technique to clinically detect a posterior vitreous detachment.
  
  
  METHODS
  In a prospective study of 30 eyes in 30 patients with macular pucker or macular hole formation, the posterior vitreous cortex was examined 1 day prior to a scheduled vitrectomy. Three independent investigators classified the posterior vitreous cortex of each eye as 'attached' or 'detached' via slit-lamp biomicroscopy (BM), 10-MHz B-scan ultrasonography (I³ Innovative Imaging Inc.), and optical coherence tomography [OCT III Stratus(®) (Carl Zeiss Meditec Inc.) and RTVue-100 OCT (Optovue Corp.)]. These preoperative findings were then compared during a triamcinolone acetonide-assisted vitrectomy 1 day later.
  
  
  RESULTS
  Triamcinolone acetonide-assisted vitrectomy showed in 60% a posterior vitreous detachment and in 40% an attached posterior vitreous cortex. Preoperatively conducted B-scan ultrasonography and BM revealed the highest, correct evaluation of the posterior vitreous status. The prediction of the OCT was confirmed intraoperatively in 12.5%. In all other cases, the evaluation by OCT was not possible or was inadequate.
  
  
  CONCLUSIONS
  The prognostic most reliable but investigator-dependent methods to clinically detect whether the posterior vitreous cortex is detached are B-scan ultrasonography and BM. The objective technique of the high-resolution, two-dimensional time-domain OCT allows only in a few cases a clear differentiation of preretinal structures.
authors.affiliation: Department of Ophthalmology, Philipps University Marburg, Marburg, Germany. nadiakicova@googlemail.com
authors.forename: Nadia
authors.initials: N
authors.lastname: Kičová
authors.forename: Thomas
authors.initials: T
authors.lastname: Bertelmann
authors.forename: Sebastian
authors.initials: S
authors.lastname: Irle
authors.forename: Walter
authors.initials: W
authors.lastname: Sekundo
authors.forename: Stefan
authors.initials: S
authors.lastname: Mennel
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D033401:Microscopy, Acoustic; D008875:Middle Aged; D057972:Posterior Eye Segment / Q000473:pathology*; D011446:Prospective Studies; D015203:Reproducibility of Results; D012164:Retinal Diseases / Q000601:surgery; D041623:Tomography, Optical Coherence; D014222:Triamcinolone Acetonide; D014821:Vitrectomy; D014822:Vitreous Body / Q000473:pathology; D020255:Vitreous Detachment / Q000175:diagnosis* / Q000601:surgery
chemical_list: D014222:Triamcinolone Acetonide