Posterior vitreous detachment and macular anatomical changes - a tomographic-electroretinographic study.
OBJECTIVE
Posterior vitreous detachment (PVD) is a physiological phenomenon due to aging characterized by separation of the vitreous cortex from the retina and may induce a variety of pathological events at the vitreoretinal junction. The aim of this study is to highlight in vivo anatomical and functional changes in early stages of PVD allowing the correct treatment.


METHODS
Non-consecutive case series; optical coherence tomography (OCT) relies on analyzing the reflectivity of coherent light from different anatomical interfaces within posterior vitreous and retinal histological layers, thus acquiring transverse sections through vitreoretinal interface, sensory retina, retinal pigment epithelium and choroid. Modern techniques using Fourier spectral analysis of the reflected light enhance axial resolution to 5-10 μm, almost matching classic histological sections. Integrating these sections, OCT can reconstruct three-dimensional tissue anatomy. Full-field electroretinogram (ERG) evaluates the function of the entire retina evoked by a flash light.


RESULTS
Imaging of the vitreoretinal interface with OCT allowed staging PVD and correctly diagnosing its secondary pathologies: cystoid macular edema, vitreomacular traction syndrome, epiretinal membrane, macular pucker, macular hole, macular pseudohole, lamellar macular hole. The cone response of full-field ERG is a marker of retinal damage in macular pathology due to PVD.


CONCLUSIONS
Correct understanding of vitreoretinal anatomic and functional changes due to posterior vitreous detachment is essential for a proper diagnosis and treatment.
Department of Physiology, University of Medicine and Pharmacy of Craiova, Romania; corici.andreea@gmail.com.
Alin Ştefan
AŞ
Ştefănescu-Dima
Cornelia Andreea
CA
Corîci
Maria Rodica
MR
Mănescu
Teodor Nicuşor
TN
Sas
Maria
M
Iancău
Carmen LuminiŢa
CL
Mocanu
D000328:Adult; D000368:Aged; D004596:Electroretinography / Q000379:methods*; D019773:Epiretinal Membrane / Q000473:pathology; D005260:Female; D005654:Fundus Oculi; D006801:Humans; D008266:Macula Lutea / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012160:Retina / Q000473:pathology; D041623:Tomography, Optical Coherence / Q000379:methods*; D020255:Vitreous Detachment / Q000473:pathology*