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VitreousDisease

VitreousDisease. The 4th department of China Medical University The department of ophthalmology of China Medical University. Introduction. Comprehend the morphous 、 constitution feature and physiologic function of vitreous Comprehend the general exam method of vitreous

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VitreousDisease

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  1. VitreousDisease The 4th department of China Medical University The department of ophthalmology of China Medical University

  2. Introduction • Comprehend the morphous、 constitution feature and physiologic function of vitreous • Comprehend the general exam method of vitreous • Comprehend the causes of Turbidity • Comprehend the treatment of Turbidity (including operation of vitreous )

  3. Morphous feature

  4. Constitution feature • Vitreous—transparent gel • 99%: water • 1%: collagen & hyaluronic acid • No blood vessels • Synchysis • Turbidity

  5. Physiologic function • Function of vitreous body • Maintain eyeball shape • Refractive media • Elasticity • Metabolism

  6. General exam method of vitreous • Direct ophthalmoscope • three-mirror contact lens • Indirect ophthalmoscope78/90D preset lens • eyeground photography • Ultrasound B

  7. Synchysis • Pathological feature • Liquefaction :metabolism、oxidation reaction-- degradation of hyaluronic acid and collapse of collagen frame • Syneresis: collapse of collagen frame • Correlate factors: age 、axis oculi、without len、myopia 、trauma 、inflimation、hemorrhage and so on .

  8. Posterior vitreous detachment(PVD) PVD:the separation betwee postcortex and retina. Photopsia Rhegmatogenous retinal detachment，(RRD) Abnormality of V-R borderline Tractive syndrome frontal membrane、IMH

  9. Acute PVD PVD Without complicatio (85%) Tears retinal /hemorrhage (10-15%) retinal vessel avulsion/ hemorrhage (rare)

  10. Degeneration of vitreous • Asteroid hyalosis • Aynchysis scintillans • Amyloidosis

  11. Muscae volitants AND Floaters • Physiological Muscae volitants embryo cell residueaerial image • Floaters Liquefaction Syneresis PVD Inflammation hemorrhage

  12. Vitreous hemorrhage • Secondary • Etiology: • Retinal vascular disease • Trauma or operation • Others: RD, PVD

  13. Vitreous hemorrhage • C.M. • Mild: floatings, vision blur • Severe: • turbidity • Vision decreased to LP • Red reflex dissappear • Complications: • Tractive RD • Ghost cell glaucoma

  14. Vitreous hemorrhage • D.D. • B-us examination • RD • Intraocular tumor

  15. Vitreous hemorrhage • Treatment: • Non-traumatic: • Conservative: absorbants • Vitrectomy: 3-6 mons • Traumatic: • Vitrectomy in 2-3 wks

  16. PVR (proliferative vitreo-retinopathy • Caused by rhegmatogenous RD & penetrating eye injury. • It is an excessive repair process. • Cell-mediated pathologic process

  17. PVR

  18. Other Vitreous Disease • Vitreous inflammation • Vitreous parasite • Familial exudative vitreoretinopathy (FEV) • Vitreous dysplasia1. tunica vasculosa lentis 2. persistent hyperplasia of primary vitreous 3. Blood vessel loop of frontal optic disc

  19. Operation on vitreous • Standard three incision 4mm behind limbus corneae • Indication retinal vascular disease complicated RD complicated ocular trauma macula lutea disease vitreitis anterior segment of eye oper complication

  20. 25-Gauge Transconjunctiva sutureless vitrectomy system 25G TSVs • Tradition D=9mm • TSV systerm D=0.5mm • Without suture line short time less painful recover quick • Indication simple vitreous hemorrhage macula lutea disease

  21. Thank you !

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