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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
Author(s) -
Kičová Nadia,
Bertelmann Thomas,
Irle Sebastian,
Sekundo Walter,
Mennel Stefan
Publication year - 2012
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2011.02330.x
Subject(s) - vitrectomy , vitreous membrane , posterior vitreous detachment , medicine , optical coherence tomography , triamcinolone acetonide , ophthalmology , ultrasonography , posterior segment of eyeball , retinal detachment , visual acuity , surgery , retinal
. 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.