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Japanese Journal of Ophthalmology
Published in: Japanese Journal of Ophthalmology 4/2016

01-07-2016 | Review

Vitreous anatomy and the vitreomacular correlation

Author: Shoji Kishi

Published in: Japanese Journal of Ophthalmology | Issue 4/2016

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Abstract

The presence of a posterior precortical vitreous pocket, referred to as a precortical pocket, implies that the vitreous cortex is formed into a collagen sheet separated from the gel in the macula. Along with strong vitreoretinal attachment at the fovea, the precortical pocket plays a role in perifoveal posterior vitreous detachments, which may lead to macular holes, premacular membranes, and ring-shaped proliferation in diabetic retinopathy. I and my colleagues published pioneer studies of the vitreous in postmortem eyes. Here, the role of the precortical pocket in various vitreoretinal interface diseases is discussed. Swept-source optical coherence tomography showed development of the precortical pocket, the connecting channel, and Cloquet’s canal during early childhood. These findings raised the possibility that aqueous humor may drain into the precortical pocket. The physiologic role of the drainage route is also discussed. Crosstalk between the anterior chamber and macula is an attractive hypothesis and remains to be elucidated.
Literature
1.
Bishop PN. Structural macromolecules and supramolecular organisation of the vitreous gel. Prog Retin Eye Res. 2000;19:323–44.PubMedCrossRef
2.
Eisner G. Gross anatomy of the vitreous body. Albrecht Von Graefes Arch Klin Exp Ophthalmol. 1975;193:33–56.PubMedCrossRef
3.
Worst JG. Cisternal systems of the fully developed vitreous body in the young adult. Trans Ophthalmol Soc UK. 1977;97:550–4.PubMed
4.
Worst J. Extracapsular surgery in lens implantation (Binkhorst lecture). Part IV. Some anatomical and pathophysiological implications. J Am Intraocul Implant Soc. 1978;4:7–14.PubMedCrossRef
5.
Jongebloed WL, Worst JF. The cisternal anatomy of the vitreous body. Doc Ophthalmol. 1987;67:183–96.PubMedCrossRef
6.
Sebag J, Balazs EA. Human vitreous fibres and vitreoretinal disease. Trans Ophthalmol Soc UK. 1985;104:123–8.PubMed
7.
Sebag J. Age-related changes in human vitreous structure. Graefes Arch Clin Exp Ophthalmol. 1987;225:89–93.PubMedCrossRef
8.
Kishi S, Demaria C, Shimizu K. Vitreous cortex remnants at the fovea after spontaneous vitreous detachment. Int Ophthalmol. 1986;9:253–60.PubMedCrossRef
9.
10.
Kishi S, Shimizu K. Clinical manifestations of posterior precortical vitreous pocket in proliferative diabetic retinopathy. Ophthalmology. 1993;100:225–9.PubMedCrossRef
11.
Kishi S, Shimizu K. Oval defect in detached posterior hyaloid membrane in idiopathic preretinal macular fibrosis. Am J Ophthalmol. 1994;118:451–6.PubMedCrossRef
12.
Kishi S, Hagimura N, Shimizu K. The role of the premacular liquefied pocket and premacular vitreous cortex in idiopathic macular hole development. Am J Ophthalmol. 1996;122:622–8.PubMedCrossRef
13.
14.
Shimada H, Hirose T, Yamamoto A, Nakashizuka H, Hattori T, Yuzawa M. Depiction of the vitreous pocket by optical coherence tomography. Int Ophthalmol. 2011;31:51–3.PubMedCrossRef
15.
Itakura H, Kishi S, Li D, Akiyama H. Observation of posterior precortical vitreous pocket using swept-source optical coherence tomography. Invest Ophthalmol Vis Sci. 2013;54:3102–7.PubMedCrossRef
16.
Schaal KB, Pang CE, Pozzoni MC, Engelbert M. The premacular bursa’s shape revealed in vivo by swept-source optical coherence tomography. Ophthalmology. 2014;121:1020–8.PubMedCrossRef
17.
Yokoi T, Toriyama N, Yamane T, Nakayama Y, Nishina S, Azuma N. Development of a premacular vitreous pocket. JAMA Ophthalmol. 2013;131:1095–6.PubMedCrossRef
18.
Li D, Kishi S, Itakura H, Ikeda F, Akiyama H. Posterior precortical vitreous pockets and connecting channels in children on swept-source optical coherence tomography. Invest Ophthalmol Vis Sci. 2014;55:2412–6.PubMedCrossRef
19.
Gabelt BT, Kaufman PL. Production and flow of aqueous humor. In: Wu SM, Kaufman PL, Alm A, editors. Levin LA, Nilsson SFE, Ver Hoeve J. 11th ed. Elsevier: Adler’s physiology of the eye. Philadelphia; 2011. p. 274–307.
20.
Gass JD, Norton EW. Cystoid macular edema and papilledema following cataract extraction. A fluorescein fundoscopic and angiographic study. Arch Ophthalmol. 1966;76:646–61.PubMedCrossRef
21.
Irvine AR, Bresky R, Crowder BM, Forster RK, Hunter DM, Kulvin SM. Macular edema after cataract extraction. Ann Ophthalmol. 1971;3:1234–5.PubMed
22.
Miyake K, Ota I, Maekubo K, Ichihashi S, Miyake S. Latanoprost accelerates disruption of the blood-aqueous barrier and the incidence of angiographic cystoid macular edema in early postoperative pseudophakias. Arch Ophthalmol. 1999;117:34–40.PubMedCrossRef
23.
Sakamoto T, Miyazaki M, Hisatomi T, Nakamura T, Ueno A, Itaya K, et al. Triamcinolone-assisted pars plana vitrectomy improves the surgical procedures and decreases the postoperative blood-ocular barrier breakdown. Graefes Arch Clin Exp Ophthalmol. 2002;240:423–9.PubMedCrossRef
24.
Fine HF, Spaide RF. Visualization of the posterior precortical vitreous pocket in vivo with triamcinolone. Arch Ophthalmol. 2006;124:1663.PubMedCrossRef
25.
Shimada H, Nakashizuka H, Hattori T, Mori R, Mizutani Y, Yuzawa M. Three-dimensional depiction of the vitreous pocket using triamcinolone acetonide. Eur J Ophthalmol. 2009;19:1102–5.PubMed
26.
Sakamoto T, Ishibashi T. Visualizing vitreous in vitrectomy by triamcinolone. Graefes Arch Clin Exp Ophthalmol. 2009;247:1153–63.PubMedCrossRef
27.
Otani T, Kishi S. Surgically induced posterior vitreous detachment by tearing the premacular vitreous cortex. Retina. 2009;29:1193–4.PubMedCrossRef
28.
Sato T, Kishi S, Otani T, Hashimoto H, Watanabe G. Modified technique for inducing posterior vitreous detachment through the posterior precortical vitreous pocket during microincision vitreous surgery with a wide-angle viewing system. Ophthalmologica. 2013;230:76–80.PubMedCrossRef
29.
Itakura H, Kishi S. Alterations of posterior precortical vitreous pockets with positional changes. Retina. 2013;33:1417–20.PubMedCrossRef
30.
Itakura H, Kishi S, Li D, Akiyama H. En face imaging of posterior precortical vitreous pockets using swept-source optical coherence tomography. Invest Ophthalmol Vis Sci. 2015;56:2898–900.PubMedCrossRef
31.
Eisner G. Biomicroscopy of the peripheral fundus. New York: Springer; 1979. p. 20, 21, 106–7.
32.
Worst JG, Los LI. Cisternal anatomy of the vitreous. Amsterdam: Kugler; 1995. p. 9–31.
33.
Sebag J. Age-related differences in the human vitreoretinal interface. Arch Ophthalmol. 1991;109:966–71.PubMedCrossRef
34.
Sebag J, Balazs EA. Morphology and ultrastructure of human vitreous fibers. Invest Ophthalmol Vis Sci. 1989;30:1867–71.PubMed
35.
Foos RY. Vitreoretinal juncture; topographical variations. Invest Ophthalmol. 1972;11:801–8.PubMed
36.
Spaide RF, Wong D, Fisher Y, Goldbaum M. Correlation of vitreous attachment and foveal deformation in early macular hole states. Am J Ophthalmol. 2002;133:226–9.PubMedCrossRef
37.
Duker JS, Kaiser PK, Binder S, de Smet MD, Gaudric A, Reichel E, et al. The International Vitreomacular Traction Study Group classification of vitreomacular adhesion, traction, and macular hole. Ophthalmology. 2013;120:2611–9.PubMedCrossRef
38.
Balazs EA, Denlinger J. Aging change in the vitreous. In: Sekuler R, Dismukes K, Kline D, National Research Council (U.S.). Committee on Vision, editors. Aging and human visual function. New York: Alan R. Liss; 1982. p. 45–7.
39.
Foos RY, Wheeler NC. Vitreoretinal juncture. Synchysis senilis and posterior vitreous detachment. Ophthalmology. 1982;89:1502–12.PubMedCrossRef
40.
Johnson MW. Posterior vitreous detachment: evolution and complications of its early stages. Am J Ophthalmol. 2010;149:371–82.PubMedCrossRef
41.
Uchino E, Uemura A, Ohba N. Initial stages of posterior vitreous detachment in healthy eyes of older persons evaluated by optical coherence tomography. Arch Ophthalmol. 2001;119:1475–9.PubMedCrossRef
42.
Itakura H, Kishi S. Evolution of vitreomacular detachment in healthy subjects. JAMA Ophthalmol. 2013;131:1348–52.PubMedCrossRef
43.
Sebag J. Anomalous posterior vitreous detachment: a unifying concept in vitreo-retinal disease. Graefes Arch Clin Exp Ophthalmol. 2004;242:690–8.PubMedCrossRef
44.
Sebag J, Gupta P, Rosen RR, Garcia P, Sadun AA. Macular holes and macular pucker: the role of vitreoschisis as imaged by optical coherence tomography/scanning laser ophthalmoscopy. Trans Am Ophthalmol Soc. 2007;105:121–9 discussion 129–31.PubMedPubMedCentral
45.
Sebag J, Niemeyer M, Koss JM. Anomalous posterior vitreous detachment and vitreoschisis. In: Sebag J, editor. Vitreous in health and disease. New York: Springer; 2014. p. 251–3.
46.
Itakura H, Kishi S. Vitreous cortex splitting in cases of vitreomacular traction syndrome. Ophthal Surg Lasers Imaging. 2012;43(Online):e27–9.
47.
Yamashita T, Uemura A, Sakamoto T. Intraoperative characteristics of the posterior vitreous cortex in patients with epiretinal membrane. Graefes Arch Clin Exp Ophthalmol. 2008;246:333–7.PubMedCrossRef
48.
49.
Avila MP, Jalkh AE, Murakami K, Trempe CL, Schepens CL. Biomicroscopic study of the vitreous in macular breaks. Ophthalmology. 1983;90:1277–83.PubMedCrossRef
50.
Gass JD. Idiopathic senile macular hole. Its early stages and pathogenesis. Arch Ophthalmol. 1988;106:629–39.PubMedCrossRef
51.
Kishi S, Kamei Y, Shimizu K. Tractional elevation of Henle’s fiber layer in idiopathic macular holes. Am J Ophthalmol. 1995;120:486–96.PubMedCrossRef
52.
Johnson MW, Van Newkirk MR, Meyer KA. Perifoveal vitreous detachment is the primary pathogenic event in idiopathic macular hole formation. Arch Ophthalmol. 2001;119:215–22.PubMed
53.
Gaudric A, Haouchine B, Massin P, Paques M, Blain P, Erginay A. Macular hole formation: new data provided by optical coherence tomography. Arch Ophthalmol. 1999;117:744–51.PubMedCrossRef
54.
Kishi S, Takahashi H. Three-dimensional observations of developing macular holes. Am J Ophthalmol. 2000;130:65–75.PubMedCrossRef
55.
Haouchine B, Massin P, Gaudric A. Foveal pseudocyst as the first step in macular hole formation. Ophthalmology. 2001;108:15–22.PubMedCrossRef
56.
Takahashi A, Yoshida A, Nagaoka T, Kagokawa H, Kato Y, Takamiya A, et al. Macular hole formation in fellow eyes with a perifoveal posterior vitreous detachment of patients with a unilateral macular hole. Am J Ophthalmol. 2011;151:981–9.PubMedCrossRef
57.
Takahashi A, Yoshida A, Nagaoka T, Takamiya A, Sato E, Kagokawa H, et al. Idiopathic full-thickness macular holes and the vitreomacular interface: a high-resolution spectral-domain optical coherence tomography study. Am J Ophthalmol. 2012;154:881–92.PubMedCrossRef
58.
Mori K, Gehlbach PL, Kishi S. Posterior vitreous mobility delineated by tracking of optical coherence tomography images in eyes with idiopathic macular holes. Am J Ophthalmol. 2015;159:1132–41.PubMedCrossRef
59.
Akiba J, Yoshida A, Trempe CL. Risk of developing a macular hole. Arch Ophthalmol. 1990;108:1088–90.PubMedCrossRef
60.
Kakehashi A, Schepens CL, Akiba J, Hikichi T, Trempe CL. Spontaneous resolution of foveal detachments and macular breaks. Am J Ophthalmol. 1995;120:767–75.PubMedCrossRef
61.
Ebato K, Kishi S. Spontaneous closure of macular hole after posterior vitreous detachment. Ophthalmic Surg Lasers. 2000;31:245–7.PubMed
62.
Hamano R, Shimoda Y, Kishi S. Tomographic features of spontaneous closure of full-thickness macular holes. Jpn J Ophthalmol. 2007;51:76–7.PubMedCrossRef
63.
Takahashi H, Kishi S. Tomographic features of a lamellar macular hole formation and a lamellar hole that progressed to a full thickness macular hole. Am J Ophthalmol. 2000;130:677–9.PubMedCrossRef
64.
Yamada N, Kishi S. Tomographic features and surgical outcomes of vitreomacular traction syndrome. Am J Ophthalmol. 2005;139:112–7.PubMedCrossRef
65.
Koizumi H, Spaide RF, Fisher YL, Freund KB, Klancnik JM Jr, Yannuzzi LA. Three-dimensional evaluation of vitreomacular traction and epiretinal membrane using spectral-domain optical coherence tomography. Am J Ophthalmol. 2008;145:509–17.PubMedCrossRef
66.
Wise GN. Clinical features of idiopathic preretinal macular fibrosis. Schoenberg Lecture. Am J Ophthalmol. 1975;79:349–57.PubMedCrossRef
67.
Appiah AP, Hirose T, Kado M. A review of 324 cases of idiopathic premacular gliosis. Am J Ophthalmol. 1988;106:533–5.PubMedCrossRef
68.
Sidd RJ, Fine SL, Owens SL, Patz A. Idiopathic preretinal gliosis. Am J Ophthalmol. 1982;94:44–8.PubMedCrossRef
69.
Hirokawa H, Jalkh AE, Takahashi M, Takahashi M, Trempe CL, Schepens CL. Role of the vitreous in idiopathic preretinal macular fibrosis. Am J Ophthalmol. 1986;101:166–9.PubMedCrossRef
70.
Heilskov TW, Massicotte SJ, Folk JC. Epiretinal macular membranes in eyes with attached posterior cortical vitreous. Retina. 1996;16:279–84.PubMedCrossRef
71.
Sumers KD, Jampol LM, Goldberg MF, Huamonte FU. Spontaneous separation of epiretinal membranes. Arch Ophthalmol. 1980;98:318–20.PubMedCrossRef
72.
Greven CM, Slusher MM, Weaver RG. Epiretinal membrane release and posterior vitreous detachment. Ophthalmology. 1988;95:902–5.PubMedCrossRef
73.
Matsumura M, Okada M, Shirakawa H, Ogino N. Histological classification of idiopathic epimacular membranes. Folia Ophthalmol Jpn. 1988;39:689–95.
74.
Okada M, Ogino N, Matsumura M, Honda Y, Nagai Y. Histological and immunohistochemical study of idiopathic epiretinal membrane. Ophthalmic Res. 1995;27:118–28.PubMedCrossRef
75.
Kampik A, Green WR, Michels RG, Nase PK. Ultrastructural features of progressive idiopathic epiretinal membrane removed by vitreous surgery. Am J Ophthalmol. 1980;90:797–809.PubMedCrossRef
76.
Kohno RI, Hata Y, Kawahara S, Kita T, Arita R, Mochizuki Y, et al. Possible contribution of hyalocytes to idiopathic epiretinal membrane formation and its contraction. Br J Ophthalmol. 2009;93:1020–6.PubMedCrossRef
77.
McMeel JW. Diabetic retinopathy: fibrotic proliferation and retinal detachment. Trans Am Ophthalmol Soc. 1971;69:440–93.PubMedPubMedCentral
78.
Kishi S. Proliferative diabetic retinopathy. In: Optical coherence tomography in diagnosis of retinal disease, 2nd edition (in Japanese, translated by author). Tokyo: Elsevier Japan; 2010. p. 190.
79.
Kishi S. The vitreous and the macula. Nippon Ganka Gakkai Zasshi. 2015;119:117–44 (in Japanese).PubMed
80.
Otani T, Kishi S, Maruyama Y. Patterns of diabetic macular edema with optical coherence tomography. Am J Ophthalmol. 1999;127:688–93.PubMedCrossRef
81.
Lewis H, Abrams GW, Blumenkranz MS, Campo RV. Vitrectomy for diabetic macular traction and edema associated with posterior hyaloidal traction. Ophthalmology. 1992;99:753–9.PubMedCrossRef
82.
Tachi N, Ogino N. Vitrectomy for diffuse macular edema in cases of diabetic retinopathy. Am J Ophthalmol. 1996;122:258–60.PubMedCrossRef
83.
Gandorfer A, Messmer EM, Ulbig MW, Kampik A. Resolution of diabetic macular edema after surgical removal of the posterior hyaloid and the inner limiting membrane. Retina. 2000;20:126–33.PubMedCrossRef
84.
Kaiser PK, Riemann CD, Sears JE, Lewis H. Macular traction detachment and diabetic macular edema associated with posterior hyaloidal traction. Am J Ophthalmol. 2001;131:44–9.PubMedCrossRef
85.
Yamaguchi Y, Otani T, Kishi S. Resolution of diabetic cystoid macular edema associated with spontaneous vitreofoveal separation. Am J Ophthalmol. 2003;135:116–8.PubMedCrossRef
86.
Gaucher D, Tadayoni R, Erginay A, Haouchine B, Gaudric A, Massin P. Optical coherence tomography assessment of the vitreoretinal relationship in diabetic macular edema. Am J Ophthalmol. 2005;139:807–13.PubMedCrossRef
87.
Kishi S. Visualization of the vitreous using swept source optical coherence tomography (in Japanese, translated by author). Nihon no Ganka 2014;85:1394–8.
88.
Takano M, Kishi S. Foveal retinoschisis and retinal detachment in severely myopic eyes with posterior staphyloma. Am J Ophthalmol. 1999;128:472–6.PubMedCrossRef
89.
Baba T, Ohno-Matsui K, Futagami S, Yoshida T, Yasuzumi K, Kojima A, et al. Prevalence and characteristics of foveal retinal detachment without macular hole in high myopia. Am J Ophthalmol. 2003;135:338–42.PubMedCrossRef
90.
Kobayashi H, Kishi S. Vitreous surgery for highly myopic eyes with foveal detachment and retinoschisis. Ophthalmology. 2003;110:1702–7.PubMedCrossRef
91.
Kanda S, Uemura A, Sakamoto Y, Kita H. Vitrectomy with internal limiting membrane peeling for macular retinoschisis and retinal detachment without macular hole in highly myopic eyes. Am J Ophthalmol. 2003;136:177–80.PubMedCrossRef
92.
Ikuno Y, Sayanagi K, Ohji M, Kamei M, Gomi F, Harino S, et al. Vitrectomy and internal limiting membrane peeling for myopic foveoschisis. Am J Ophthalmol. 2004;137:719–24.PubMed
93.
Ikuno Y, Gomi F, Tano Y. Potent retinal arteriolar traction as a possible cause of myopic foveoschisis. Am J Ophthalmol. 2005;139:462–7.PubMedCrossRef
94.
Itakura H, Kishi S, Li D, Nitta K, Akiyama H. Vitreous changes in high myopia observed by swept-source optical coherence tomography. Invest Ophthalmol Vis Sci. 2014;55:1447–52.PubMedCrossRef
95.
Kishi S. Vitreous changes in myopia. In: Spaide RF, Ohno-Matsui K, Yannuzzi LA, editors. Pathologic Myopia. New York: Springer; 2013. p. 143–66.
96.
Bito LZ, Wallenstein MC. Transport of prostaglandins across the blood-brain and blood-aqueous barriers and the physiological significance of these absorptive transport processes. Exp Eye Res. 1977;25(Suppl):229–43.PubMedCrossRef
97.
Miyake K, Ibaraki N. Prostaglandins and cystoid macular edema. Surv Ophthalmol. 2002;47(Suppl 1):S203–18.PubMedCrossRef
98.
Miyake K. Prevention of cystoid macular edema after lens extraction by topical indomethacin (I). A preliminary report. Albrecht Von Graefes Arch Klin Exp Ophthalmol. 1977;203:81–8.PubMedCrossRef
99.
von Jagow B, Ohrloff C, Kohnen T. Macular thickness after uneventful cataract surgery determined by optical coherence tomography. Graefes Arch Clin Exp Ophthalmol. 2007;245:1765–71.CrossRef
100.
101.
Hesse RJ, Swan JL II. Aphakic cystoid macular edema secondary to betaxolol therapy. Ophthalmic Surg. 1988;19:562–4.PubMed
102.
Miyake K, Ota I, Ibaraki N, Akura J, Ichihashi S, Shibuya Y, et al. Enhanced disruption of the blood-aqueous barrier and the incidence of angiographic cystoid macular edema by topical timolol and its preservative in early postoperative pseudophakia. Arch Ophthalmol. 2001;119:387–94.PubMedCrossRef
103.
Moroi SE, Gottfredsdottir MS, Schteingart MT, Elner SG, Lee CM, Schertzer RM, et al. Cystoid macular edema associated with latanoprost therapy in a case series of patients with glaucoma and ocular hypertension. Ophthalmology. 1999;106:1024–9.PubMedCrossRef
104.
Wong DC, Waxman MD, Herrinton LJ, Shorstein NH. Transient macular edema after intracameral injection of a moderately elevated dose of cefuroxime during phacoemulsification surgery. JAMA Ophthalmol. 2015;133:1194–7.PubMedCrossRef
105.
Tolentino FI, Schepens CL, Freeman HM. Vitreoretinal disorders. Diagnosis and management. Philadelphia: W.B. Saunders Co.; 1976. p. 121–2.
106.
Tolentino FI, Schepens CL, Freeman HM. Vitreoretinal disorders. Diagnosis and management. Philadelphia: W.B. Saunders Co.; 1976. p. 109–16.
107.
Wiegand RD, Giusto NM, Rapp LM, Anderson RE. Evidence for rod outer segment lipid peroxidation following constant illumination of the rat retina. Invest Ophthalmol Vis Sci. 1983;24:1433–5.PubMed
108.
Nomura Y, Takahashi H, Tan X, Fujino Y, Kawashima H, Yanagi Y. Effect of posterior vitreous detachment on aqueous humor level of vascular endothelial growth factor in exudative age-related macular degeneration patients. Graefes Arch Clin Exp Ophthalmol. 2016;254:53–7.PubMedCrossRef
Metadata
Title
Vitreous anatomy and the vitreomacular correlation
Author
Shoji Kishi
Publication date
01-07-2016
Publisher
Springer Japan
Published in
Japanese Journal of Ophthalmology / Issue 4/2016
Print ISSN: 0021-5155
Electronic ISSN: 1613-2246
DOI
https://doi.org/10.1007/s10384-016-0447-z

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