The Pathophysiology of Vitreomacular Interface Disease

2018 ◽  
pp. 224-230
Keyword(s):  
Surgical Treatment ◽  
Posterior Vitreous Detachment ◽  
Vitreous Body ◽  
Treatment Modalities ◽  
Clear Understanding ◽  
Vitreoretinal Interface ◽  
Vitreous Detachment ◽  
Vitreomacular Interface ◽  
Anomalous Posterior Vitreous Detachment

Anomalous posterior vitreous detachment is an important step in the pathogenesis of vitreoretinal interface diseases. In order to understand the pathophysiology of vitreoretinal interface diseases, the structure and biochemistry of the vitreous body, and its relation with the retina should be investigated. Having a clear understanding of the pathophysiology of these diseases may help to develop new pharmacologic or surgical treatment modalities.

scholarly journals Macro-Microscopic Study of Posterior Vitreous Detachment Variants in an Ex Vivo Experiment

2020 ◽  
pp. 50-55
Author(s):  
N.M. Kislitsyna ◽  
◽  
A.V. Shatskikh ◽  
S.M. Dibirova ◽  
D.M. Sultanova ◽  
...  
Keyword(s):  
Ex Vivo ◽  
Posterior Vitreous Detachment ◽  
Vitreous Body ◽  
Internal Limiting Membrane ◽  
Original Method ◽  
Layer By Layer ◽  
Cortical Layers ◽  
Vitreoretinal Interface ◽  
Boundary Area ◽  
Vitreous Detachment

Purpose. The key to understanding the development of any vitreoretinal pathology is a presence of a clear conception to possible variants of changes in the anatomical and topographic relationships of the posterior cortical layers of the vitreous body and the retinal internal limiting membrane (ILM) in a formation of posterior vitreous detachment (PVD). An original method of macro-microscopic examinations of anatomical objects proposed by professor V.P. Vorobyov, which includes investigations of morphological objects whose dimensions lie in the boundary area between macroscopic parameters studied by anatomists and microstructures studied by histologists, discover a new boundary area for the study of anatomical structures. However, it has not been practically used in ophthalmology until now. The study of a process for changes in the vitreoretinal interface during the PVD occurrence is difficult due to a complexity of simulation, a possibility of visualization, and an absence of approved protocols for macro-microscopic research. Purpose. To study variants of anatomical and topographical changes in the vitreoretinal interface during the formation of induced PVD in ex vivo experiments using the method of macro-microscopic examination. Material and methods. The study was performed in 24 eyeballs of cadaver donors. To assess changes in the vitreoretinal interface in the process of PVD induction, an original method of dissection was used, that allows to isolate layer-by-layer the cortical layers of the vitreous body and the retinal ILM, with a possibility of further evaluation of changes in the vitreoretinal interface by the macro-microscopic examination. Salt barium sulfate suspension Video-contrast was used with the purpose to contrast vitreous fibers. Macroscopic investigation was carried out using the Topcon OMS-800 operating microscope with an indication from x8 to x21 magnification, microscopic changes were evaluated by the light microscopy method with x50, x100, x200, x400 x630 magnification using the Leica DM LB2 microscope with the subsequent photo registration. Results. During the macro-microscopic study, three variants of possible changes in the vitreoretinal interface during the development of induced PVD were revealed, which were interpreted as the normal (true) PVD and abnormal PVD, which occurred both with the formation (the variant A) of vitreoschisis zones (exfoliation of the cortical layers of the vitreous body) and with the zones of retinal ILM exfoliation (the variant B). Conclusion. The proposed method of macro-microscopic investigation of the vitreoretinal interface allows to dissect isolated sequentially layer-by-layer the cortical layers of the vitreous body and the retinal ILM with subsequent fixation on a special substrate according to the original method and the possibility to carry out a histological section and its evaluation by the light microscopy method. The application of the developed method allows to accurately assess changes in the vitreoretinal interface on any isolated site of the vitreoretinal surface. The presented work demonstrates possibilities for the application of the method to detect variants of changes in the vitreoretinal interface within the formation of induced PVD. Keywords: posterior vitreous detachment, internal limiting membrane, dissection of the vitreous body, vitreoretinal interface.

scholarly journals Modern Possibilities for the Vireoretinal Interface Contrasting (Experimental Study)

2018 ◽  
Vol 15 (2S) ◽  
pp. 231-238 ◽  
Author(s):  
N. M. Kislitsyna ◽  
S. V. Kolesnik ◽  
S. V. Novikov ◽  
A. I. Kolesnik ◽  
M. P. Veselkova
Keyword(s):  
Morphological Analysis ◽  
Posterior Vitreous Detachment ◽  
Vitreous Body ◽  
Vitreoretinal Surgery ◽  
Vitreoretinal Interface ◽  
Vitreous Detachment ◽  
Vitreous Cortex ◽  
Thin Membranes ◽  
Fine Structures ◽  
The Ideal

The contrast agents in vitreoretinal surgery are necessary to ensure the visualization of translucent and ultra-thin membranes and vitreoretinal interface (VRI) structures, but the ideal staining agent has not been found yet.Purpose. To investigate and compare staining properties of two vital dyes for vitreous body (VB) and vitreoretinal interface visualization: “Kenalog-40” and “Vitreocontrast”.Patients and methods. The study was performed on 20 cadaveric eyes. After eyeball dissection with the original technology, we carried out posterior vitreous cortex separation and comparative staining of retinal fragments on the side of VB and corresponding section of the VB by “Kenalog-40” and “Vitreokontrast”. Vitreo-retinal interface samples underwent morphological analysis.Results. In contrast to «Kenalog-40», «Vitreocontrast» enables the visualization of thin layer of VB on retina surface after splitting of cortical layers during posterior vitreous detachment induction. Upon that, the adherent particles of the “Vitreocontrast” suspension remained on the corresponding splitted fragment of the VB. After staining with “Kenalog-40”, the VB surface remained smooth, shiny, with no visible changes. The results of histological examination of the obtained retinal and VB samples confirmed the presence of VB layer on the retina surface at the site of vitreoshisis formation during the induction of posterior vitreous detachment.Conclutions. Received data confirm the possibility of vitreoshisis formation during posterior vitreous body detachment, and demonstrate the advantages of the staining properties of the “Vitreokontrast” suspension for visualization of fine structures of vitreoretinal interface. 

scholarly journals Physiology of Vitreous and Vitreomacular Interface and Age-Related Changes

2018 ◽  
pp. 213-219
Keyword(s):  
Extracellular Matrix ◽  
Posterior Vitreous Detachment ◽  
Natural Aging ◽  
Posterior Segment ◽  
Vitreomacular Adhesion ◽  
Vitreoretinal Interface ◽  
Age Related ◽  
Ocular Structure ◽  
Vitreomacular Interface ◽  
Age Related Changes

Vitreous is an important ocular structure in the normal physiology and pathologic conditions of the posterior segment. Vitreous is a gel-like composite structure and forms an extracellular matrix that occupies the biggest space in the eye. The healthy vitreous gel reduces oxygen tension and protects vitreous, retina, and lens from oxidative damage. Vitreous plays an important role in the refraction of the eye, preserving the transparency with regular interaction of the macromolecules contained therein. Vitreous suffer from continuous physical tension and this results in important changes. Particularly age-related degeneration in the structure of the vitreous gel leads to a decrease in vitreoretinal adhesion. As part of natural aging, the posterior vitreous detachment process may become pathologic when the vitreoretinal interface weakens simultaneously with vitreous liquefaction. In this process, vision-threatening diseases such as vitreomacular adhesion, vitreomacular traction, and macula hole may appear.

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.

scholarly journals Age-related changes of the vitreous body

2019 ◽  
Vol 100 (1) ◽  
pp. 170-174
Author(s):  
S D Stebnev ◽  
V S Stebnev ◽  
I V Malov ◽  
V M Malov ◽  
E B Eroshevskaya
Keyword(s):  
Posterior Vitreous Detachment ◽  
Vitreous Body ◽  
Vitreous Detachment ◽  
Age Related ◽  
Macular Holes ◽  
Retinal Disorders ◽  
Viscoelastic Structure ◽  
Idiopathic Macular Holes ◽  
Strength And Plasticity ◽  
Age Related Changes

Innovative advances in recent years in the study of pathological changes of the posterior segment of the eye including the use of optical coherence tomography which is considered the gold standard for diagnosing vitreoretinal interface pathology, not only significantly expanded the idea of the most prevalent lesions of the structure of posterior eye segment but also discovered absolutely new aspects of their pathology. The review emphasizes the spreading understanding of vitreous body, its age-related changes in the pathology of the posterior eye segment. Two main interrelated processes occurring in the vitreous body - synchysis and syneresis, gradually increasing with age, are considered. Synchysis process begins at the early age and by the age of 70 reaches 50% of the volume of the vitreous body in 70% of the population. Parallelly, syneresis provides strength and plasticity of the entire vitreous volume due to collagen involved in formation of fibrillar frame. An important role in maintaining a stable and viscoelastic structure of the vitreous body, belonging to hyaluronic acid, is discussed, the level of which remains relatively stable at any age due to its constant synthesis. The accumulated data on the structure of age-related and pathological biodegradation of the vitreous body demonstrates inevitable progression of this process leading to age-related posterior vitreous detachment, which is a detachment of the posterior cortical layers of the vitreous body from subjacent retina. Posterior detachment under the influence of age-related changes in the vitreous body has certain stages - from incomplete juxtafoveolar detachment to complete posterior vitreous detachment with clinical retinal changes corresponding to each stage (idiopathic macular holes, lamellar macular tears, macular fibrosis, vitreomacular traction syndrome, myopic foveoschisis). Complete posterior vitreous detachment usually does not cause anatomical retinal disorders and any clinical forms of its diseases, thus, it can be considered as a natural favorable outcome.

scholarly journals Embryology and Anatomy of Vitreus and Vitreomacular Interface

2018 ◽  
pp. 209-212
Keyword(s):  
Diabetic Retinopathy ◽  
Posterior Vitreous Detachment ◽  
Retinal Diseases ◽  
Anatomic Site ◽  
Vitreoretinal Interface ◽  
Physiological Processes ◽  
Macular Holes ◽  
Vitreomacular Interface ◽  
New Treatment ◽  
Retinal Vein Occlusions

The vitreous is a tissue that has important functions in various physiological processes in the eye. The vitreoretinal interface is an important anatomic site in the pathophysiology of various vitreomaculopathies. It has been understood that abnormal posterior vitreous detachment plays an important role in a variety of retinal diseases such as macular holes, macular wrinkles, and retinal detachment, as well as in promoting a number of comorbidities such as diabetic retinopathy, retinal vein occlusions. Understanding the biochemistry, embryology, and anatomy of vitreous will contribute to a better understanding of these diseases and the development of new treatment methods.

scholarly journals Epidemiology of Vitreomacular Interface Disorders

2018 ◽  
pp. 220-223
Keyword(s):  
Macular Hole ◽  
Epiretinal Membrane ◽  
Visual Loss ◽  
Disease Duration ◽  
Posterior Vitreous Detachment ◽  
Vitreomacular Adhesion ◽  
Membrane Formation ◽  
Vitreous Detachment ◽  
Vitreomacular Interface ◽  
Epidemiological Characteristics

Vitreomacular interface disorders consist of a series of diseases including vitreomacular adhesion, vitreomacular traction, macular hole, and epiretinal membrane formation. They occur due to the failed progression of normal posterior vitreous detachment. Affected patients may present with metamorphopsia and varying degrees of visual loss depending on the severity of foveal disturbance and disease duration. The aim of this review is to define the epidemiological characteristics of these groups of disorders which show an increased incidence and prevalence with age in parallel with the occurrence of posterior vitreous detachment.

Sign in / Sign up

Export Citation Format

Share Document