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Ma, Feiyan MD; Arcinue, Cheryl A. MD; Barteselli, Giulio MD; Cheng, Lingyun MD; Ezon, Isaac MD; Lee, Su Na MD; Freeman, William R. MD

doi: 10.1097/IAE.0000000000000025
Original Study

Purpose: To describe the vitreoretinal interface of the asymptomatic fellow eyes of patients with acute unilateral posterior vitreous detachment (PVD) based on biomicroscopic examination and spectral domain optical coherence tomography.

Methods: Sixty-five eyes of 65 consecutive patients with acute unilateral PVD were examined by slit-lamp, indirect ophthalmoscopy, and spectral domain optical coherence tomography. The state of PVD in different retinal locations and premacular pocket were assessed and graded using spectral domain optical coherence tomography.

Results: Nine eyes (13.85%) had no PVD, 15 (23.08%) had extrafoveal vitreous separation (Stage 1), 18 (27.69%) had partial foveal vitreous separation (Stage 2), 12 (18.46%) had complete foveal vitreous separation (Stage 3), and 11 (16.92%) had a complete PVD (Stage 4). The presence of a premacular pocket showed equal distribution in Stages 0, 1, and 2 (66.67, 80.00, and 77.78%, respectively) but was significantly less common in Stages 3 (P = 0.016) and 4 (P < 0.0001). Only certain posterior vitreous configurations were identified (P < 0.0001), suggesting an orderly progression of PVD evolution.

Conclusion: Our spectral domain optical coherence tomography-based PVD staging system describes the evolution of PVDs. This can be used as a guide in predicting the occurrence and evolution of PVD in this population.

The posterior vitreoretinal interface in asymptomatic fellow eyes of patients with symptomatic posterior vitreous detachment was examined clinically and with spectral domain optical coherence tomography. A staging system for grading posterior vitreous detachment is developed and support for the evolutionary process of posterior vitreous detachment formation is put forth.

Department of Ophthalmology, Jacobs Retina Center at Shiley Eye Center, University of California San Diego, La Jolla, California. Dr. S. N. Lee is now at the Department of Ophthalmology, Eulji University Hospital, Daejeon, Korea.

Reprint requests: William R. Freeman, MD, Department of Ophthalmology, Shiley Eye Center, University of California at San Diego, 0946, 9415 Campus Point Drive, La Jolla, CA 92037; e-mail:

Supported in part by NIH grants R01EY007366 and R01EY018589 (W.R.F.), R01EY020617 (L.C.), and an unrestricted fund from Research to Prevent Blindness to the Department of Ophthalmology, University of California San Diego.

None of the authors have any conflicting interests to disclose.

© 2014 by Ophthalmic Communications Society, Inc.