Top

BMC Ophthalmology

Published in:

Open Access 01-12-2023 | Vitrectomy | Research

Accuracy of biomicroscopy, ultrasonography and spectral-domain OCT in detection of complete posterior vitreous detachment

Authors: Jasmin Zvorničanin, Edita Zvorničanin, Maja Popović

Published in: BMC Ophthalmology | Issue 1/2023

Abstract

Background

To evaluate the accuracy of preoperative biomicroscopy (BM), ultrasonography (US), and spectral domain optical coherence tomography (SD-OCT) to determine complete posterior vitreous detachment (PVD) confirmed by intraoperative findings of triamcinolone acetonide-assisted pars plana vitrectomy (PPV).

Methods

This prospective study included all consecutive patients admitted for surgical treatment of the epiretinal membrane (ERM) and macular hole (MH). The presence of complete PVD was determined one day before PPV using BM, US, SD-OCT. The preoperative findings were compared to the PVD status determined during PPV.

Results

A total of 123 eyes from 123 patients were included in the study. Indications for PPV included ERM in 57 (46.3%), full thickness macular hole in 57 (46.3%) and lamellar macular hole in 9 (7.3%) patients. Complete PVD during PPV was observed in 18 (31.6%; 95%CI:18.7–49.9) patients with ERM and 13 (19.7%; 95%CI:10.4–33.7) patients with MH. The sensitivity of preoperative BM, US, SD-OCT was 48.4% (95%CI:30.2–66.9), 61.3% (95%CI:42.2–78.2) and 54.8% (95%CI:36.0–72.7) respectively. The specificity of preoperative BM, US, SD-OCT was 81.5% (95%CI:72.1–88.9), 90.2% (95%CI:82.2–95.4) and 85.9% (95%CI:77.0–92.3) respectively. With a prevalence of 25.2% of PVD in our sample the positive predictive value of preoperative BM, US, SD-OCT was 46.9% (95%CI:29.1–65.3), 67.9% (95%CI:47.6–84.1) and 56.7% (95%CI:37.4–74.5) respectively.

Conclusion

Preoperative BM, US, and SD-OCT showed relatively low sensitivity but also good specificity in assessing complete PVD. A combination of all three diagnostic methods can provide a good assessment of the vitreoretinal interface state.

Sebag J. Anomalous posterior vitreous detachment: a unifying concept in vitreo-retinal disease. Graefes Arch Clin Exp Ophthalmol. 2004;242:690–8.PubMedCrossRef

Ma F, Arcinue CA, Barteselli G, Cheng L, Ezon I, Lee SN, et al. Optical coherence tomography findings of the vitreoretinal interface in asymptomatic fellow eyes of patients with acute posterior vitreous detachment. Retina. 2014;34:447–54.PubMedCrossRef

Rezende FA, Kapusta MA, Burnier MN Jr, Costa RA, Scott IU. Preoperative B-scan ultrasonography of the vitreoretinal interface in phakic patients undergoing rhegmatogenous retinal detachment repair and its prognostic significance. Graefes Arch Clin Exp Ophthalmol. 2007;245:1295–301.PubMedCrossRef

Wallsh JO, Langevin ST, Kumar A, Huz J, Falk NS, Bhatnagar P. Fellow-Eye Retinal Detachment Risk as Stratified by Hyaloid Status on OCT. Ophthalmology. 2023;130:624–30.PubMedCrossRef

Rahman R, Murray CD, Stephenson J. Risk factors for iatrogenic retinal breaks induced by separation of posterior hyaloid face during 23-gauge pars plana vitrectomy. Eye (Lond). 2013;27:652–6.PubMedCrossRef

Ashraf M, Souka A, Adelman RA. Age-related macular degeneration: using morphological predictors to modify current treatment protocols. Acta Ophthalmol. 2018;96:120–33.PubMedCrossRef

Zheng Y, Woodward R, Feng HL, Lee T, Zhang X, Pant P, Thomas AS, Fekrat S. Implications of Complete Posterior Vitreous Detachment in Eyes with Central Retinal Vein Occlusion. Retina. 2023 Sep 5. https://doi.org/10.1097/IAE.0000000000003932. Epub ahead of print.

Anderson W, Piggott K, Bao YK, Pham H, Kavali S, Rajagopal R. Complete posterior vitreous detachment reduces the need for treatment of diabetic macular edema. Ophthalmic Surg Lasers Imaging Retina. 2019;50:e266–73.PubMedPubMedCentralCrossRef

Kičová N, Bertelmann T, Irle S, Sekundo W, Mennel S. Evaluation of a posterior vitreous detachment: a comparison of biomicroscopy, B-scan ultrasonography and optical coherence tomography to surgical findings with chromodissection. Acta Ophthalmol. 2012;90:e264–348.PubMedCrossRef

10.

Rahman R, Chaudhary R, Anand N. Verification of posterior hyaloid status during pars plana vitrectomy, after preoperative evaluation on optical coherence tomography. Retina. 2012;32:706–10.PubMedCrossRef

11.

Hwang ES, Kraker JA, Griffin KJ, Sebag J, Weinberg DV, Kim JE. Accuracy of spectral-domain OCT of the macula for detection of complete posterior vitreous detachment. Ophthalmol Retina. 2020;4:148–53.PubMedCrossRef

12.

Moon SY, Park SP, Kim YK. Evaluation of posterior vitreous detachment using ultrasonography and optical coherence tomography. Acta Ophthalmol. 2020;98:e29–35.PubMedCrossRef

13.

Pessoa B, Coelho J, Malheiro L, José D, Pires S, Coelho C, et al. Comparison of ocular ultrasound versus SD-OCT for imaging of the posterior vitreous status in patients with DME. Ophthalmic Ophthalmic Surg Lasers Imaging Retina. 2020;51:S50–3.PubMed

14.

Stavrakas P, Christou EE, Ananikas K, Tsiogka A, Tranos P, Theodossiadis P, et al. Sensitivity of spectral domain optical coherence tomography in the diagnosis of posterior vitreous detachment in vitreomacular interface disorders: A prospective cohort study. Eur J Ophthalmol. 2022;32:1114–21.CrossRef

15.

Wang MD, Truong C, Mammo Z, Hussnain SA, Chen RWS. Swept source optical coherence tomography compared to ultrasound and biomicroscopy for diagnosis of posterior vitreous detachment. Clin Ophthalmol. 2021;15:507–12.PubMedPubMedCentralCrossRef

16.

Albabtain B, Mura M, Schatz P, Alsulaiman SM, Alsakran WA, Semidey VA. Comparison of posterior hyaloid assessment using preoperative optical coherence tomography and intraoperative triamcinolone acetonide staining during vitrectomy. Clin Ophthalmol. 2021;15:3939–45.PubMedPubMedCentralCrossRef

17.

Iglicki M, Busch C, Zur D, Okada M, Mariussi M, Chhablani JK, et al. Dexamethasone implant for diabetic macular edema in naive compared with refractory eyes: The International Retina Group Real-Life 24-Month Multicenter Study. The IRGREL-DEX Study Retina. 2019;39:44–51.PubMedCrossRef

18.

Iglicki M, Zur D, Busch C, Okada M, Loewenstein A. Progression of diabetic retinopathy severity after treatment with dexamethasone implant: a 24-month cohort study the “DR-Pro-DEX Study.” Acta Diabetol. 2018;55:541–7.PubMedCrossRef

19.

Mello Filho P, Andrade G, Maia A, Maia M, Biccas Neto L, Muralha Neto A, et al. Effectiveness and Safety of Intravitreal Dexamethasone Implant (Ozurdex) in Patients with Diabetic Macular Edema: A Real-World Experience. Ophthalmologica. 2019;241:9–16.PubMedCrossRef

20.

Zur D, Iglicki M, Loewenstein A. The Role of Steroids in the Management of Diabetic Macular Edema. Ophthalmic Res. 2019;62:231–6.PubMedCrossRef

21.

Iglicki M, Zur D, Fung A, Gabrielle PH, Lupidi M, Santos R, et al. International Retina Group (IRG). TRActional DIabetic reTInal detachment surgery with co-adjuvant intravitreal dexamethasONe implant: the TRADITION STUDY. Acta Diabetol. 2019;56(10):1141–7. https://doi.org/10.1007/s00592-019-01357-y.

22.

Zur D, Iglicki M, Sala-Puigdollers A, Chhablani J, Lupidi M, Fraser-Bell S, et al. International Retina Group (IRG). Disorganization of retinal inner layers as a biomarker in patients with diabetic macular oedema treated with dexamethasone implant. Acta Ophthalmol. 2020;98(2):e217–e223. https://doi.org/10.1111/aos.14230.

23.

Iglicki M, Loewenstein A, Barak A, Schwartz S, Zur D. Outer retinal hyperreflective deposits (ORYD): a new OCT feature in naïve diabetic macular oedema after PPV with ILM peeling. Br J Ophthalmol. 2020;104:666–71.PubMedCrossRef

24.

Iglicki M, Lavaque A, Ozimek M, Negri HP, Okada M, Chhablani J, et al. Biomarkers and predictors for functional and anatomic outcomes for small gauge pars plana vitrectomy and peeling of the internal limiting membrane in naïve diabetic macular edema: The VITAL Study. PLoS ONE. 2018;13:e0200365.PubMedPubMedCentralCrossRef

25.

Iglicki M, Zur D, Negri HP, Esteves J, Arias R, Holsman E, et al. Results in comparison between 30 gauge ultrathin wall and 27 gauge needle in sutureless intraocular lens flanged technique in diabetic patients: 24-month follow-up study. Acta Diabetol. 2020;57:1151–7.PubMedCrossRef

26.

Iglicki M, González DP, Loewenstein A, Zur D. Next-generation anti-VEGF agents for diabetic macular oedema. Eye (Lond). 2022;36:273–7.PubMedCrossRef

27.

Iglicki M, Busch C, Loewenstein A, Fung AT, Invernizzi A, Mariussi M, et al. Underdiagnosed optic disk pit maculopathy: Spectral Domain Optical Coherence Tomography Features For Accurate Diagnosis. Retina. 2019;39:2161–6.PubMedCrossRef

28.

Iglicki M, González DP, Loewenstein A, Zur D. Longer-acting treatments for neovascular age-related macular degeneration-present and future. Eye (Lond). 2021;35:1111–6.PubMedCrossRef

29.

Zur D, Iglicki M, Busch C, Invernizzi A, Mariussi M, Loewenstein A. International retina group Oct biomarkers as functional outcome predictors in diabetic macular edema treated with dexamethasone implant. Ophthalmology. 2018;125:267–75.PubMedCrossRef

30.

Iglicki M, Busch C, Lanzetta P, Sarao V, Veritti D, Rassu N, et al. Vitrectomized vs non-vitrectomized eyes in DEX implant treatment for DMO-Is there any difference? the VITDEX study. Eye (Lond). 2023;37:280–4.PubMedCrossRef

31.

Iglicki M, Khoury M, Melamud JI, Donato L, Barak A, Quispe DJ, et al. Naïve subretinal haemorrhage due to neovascular age-related macular degeneration pneumatic displacement, subretinal air, and tissue plasminogen activator: subretinal vs intravitreal aflibercept-the native study. Eye (Lond). 2023;37:1659–64.PubMedCrossRef

32.

Tang F, Luenam P, Ran AR, Quadeer AA, Raman R, Sen P, et al. Detection of diabetic retinopathy from ultra-Widefield scanning laser ophthalmoscope images: a multicenter deep learning analysis. Ophthalmol Retina. 2021;5:1097–106.PubMedCrossRef

33.

Brennen PM, Kagemann L, Friberg TR. Comparison of stratus OCT and Cirrus HD-OCT imaging in macular diseases. Ophthalmic Surg Lasers Imaging. 2009;40:25–31.PubMedPubMedCentralCrossRef

34.

Kraker JA, Kim JE, Koller EC, George JC, Hwang ES. Standard 6-mm Compared with Widefield 16.5-mm OCT for Staging of Posterior Vitreous Detachment. Ophthalmol Retina. 2020;4:1093–102.PubMedCrossRef

35.

Zvorničanin J, Zvorničanin E, Husić D. Eccentric macular hole formation following successful macular hole surgery. Acta Med Acad. 2019;48:312–6.PubMedCrossRef

36.

Bergamo VC, Caiado RR, Maia A, Magalhães O Jr, Moraes NSB, Rodrigues EB, et al. Role of vital dyes in Chromovitrectomy. Asia Pac J Ophthalmol (Phila). 2020;10:26–38.PubMedCrossRef

37.

Jackson TL, Donachie PHJ, Sparrow JM, Johnston RL. United Kingdom national ophthalmology database study of vitreoretinal surgery: report 2, macular hole. Ophthalmology. 2013;120:629–34.PubMedCrossRef

38.

Marie-Louise J, Philippakis E, Darugar A, Tadayoni R, Dupas B. Occurrence rate of retinal detachment after small gauge vitrectomy for idiopathic epiretinal membrane. Eye (Lond). 2017;31:1259–65.PubMedCrossRef

39.

Luc MS, Luc A, Angioi-Duprez K, Thilly N, Berrod JP, Conart JB. Prevalence and predictive factors for posterior vitreous attachment in eyes undergoing epiretinal membrane surgery. Eye (Lond). 2022;36:1302–7.PubMedCrossRef

40.

Kishi S, Demaria C, Shimizu K. Vitreous cortex remnants at the fovea after spontaneous vitreous detachment. Int Ophthalmol. 1986;9:253–60.PubMedCrossRef

41.

Hayashi K, Sato T, Manabe SI, Hirata A. Sex-related differences in the progression of posterior vitreous detachment with age. Ophthalmol Retina. 2019;3:237–43.PubMedCrossRef

42.

Wang R, Lovenberg C, Hess O, Todorich B. Role of optical coherence tomography in management of acute posterior vitreous detachment and its complications. Retina. 2023;43:371–8.PubMedCrossRef

43.

Rothenbuehler SP, Malmqvist L, Belmouhand M, Bjerager J, Maloca PM, Larsen M, Hamann S. Comparison of spectral-domain Oct versus swept-source oct for the detection of deep optic disc Drusen. Diagnostics (Basel). 2022;12:2515.PubMedCrossRef

44.

Laíns I, Wang JC, Cui Y, Katz R, Vingopoulos F, Staurenghi G, et al. Retinal applications of swept source optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA). Prog Retin Eye Res. 2021;84:100951.PubMedCrossRef

45.

Chiku Y, Hirano T, Takahashi Y, Tuchiya A, Nakamura M, Murata T. Evaluating posterior vitreous detachment by widefield 23-mm swept-source optical coherence tomography imaging in healthy subjects. Sci Rep. 2021;11:19754.PubMedPubMedCentralCrossRef

Title: Accuracy of biomicroscopy, ultrasonography and spectral-domain OCT in detection of complete posterior vitreous detachment
Authors: Jasmin Zvorničanin
Edita Zvorničanin
Maja Popović
Publication date: 01-12-2023
Publisher: BioMed Central
Keyword: Vitrectomy
Published in: BMC Ophthalmology / Issue 1/2023
Electronic ISSN: 1471-2415
DOI: https://doi.org/10.1186/s12886-023-03233-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Accuracy of biomicroscopy, ultrasonography and spectral-domain OCT in detection of complete posterior vitreous detachment

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2023

Maresin-1 inhibits high glucose induced ferroptosis in ARPE-19 cells by activating the Nrf2/HO-1/GPX4 pathway

Visual acuity assessment of central retinal artery occlusion patients with or without paracentral acute middle maculopathy via OCT-A

Simple surgical punctal occlusion with high frequency radiowave electrosurgery

Non-typical persistent hyperplastic primary vitreous: a rare case report and review of the literature

Non-contact meibography changes according to disease activity in rheumatoid arthritis cases

Cogan’s syndrome is more than just keratitis: a case-based literature review