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Evaluation of a posterior vitreous detachment: a comparison of biomicroscopy, B-scan ultrasonography and optical coherence tomography to surgical findings with chromodissection
Article first published online: 26 JAN 2012
DOI: 10.1111/j.1755-3768.2011.02330.x
© 2012 The Authors. Acta Ophthalmologica © 2012 Acta Ophthalmologica Scandinavica Foundation
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How to Cite
Kičová, N., Bertelmann, T., Irle, S., Sekundo, W. and Mennel, S. (2012), Evaluation of a posterior vitreous detachment: a comparison of biomicroscopy, B-scan ultrasonography and optical coherence tomography to surgical findings with chromodissection. Acta Ophthalmologica, 90: e264–e268. doi: 10.1111/j.1755-3768.2011.02330.x
Publication History
- Issue published online: 28 MAY 2012
- Article first published online: 26 JAN 2012
- Received on February 11th, 2011. Accepted on October 16th, 2011.
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Keywords:
- macular hole;
- macular pucker;
- posterior vitreous cortex;
- posterior vitreous detachment;
- vitrectomy;
- vitreoretinal interface
Abstract.
Purpose: 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.
Conclusion: 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.