What Is Vitreous Detachment?

Vitreous detachment refers to the detachment of the boundary layer of the vitreous body from the inner boundary layer of the retina. This may be caused by the liquefaction of the vitreous body or the traction of the organicated cord to cause the vitreous body to contract. Corneal fistula or corneal and scleral surgical wounds that can not be cured for a long time may also induce this disease due to long-term intraocular fluid overflow that reduces the vitreous volume. Among these many reasons, it is more common in the elderly or patients with vitreous liquefaction in high myopia. This may be related to the degeneration of the eye tissue.

Vitreous detachment

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Vitreous detachment refers to the realm of vitreous body

Posterior vitreous detachment is more common in simplicity

1. Partial posterior vitreous detachment is mostly from the posterior and upper detachment to form a blister-like gap (Figure 15-2), which is filled with liquid. Later, it can become sac-like due to the gradual sinking of gravity, which is called partial posterior vitreous detachment and vitreous collapse (Figure 15-3). At this time, the vitreous body has a large traction force at the upper part connected with the retina, which easily tears the retina at this place, resulting in a horseshoe-shaped hole.

2. After complete vitreous detachment, the above-mentioned detachment continues to expand downward, and it is relatively easy to tear away the physiological adhesion of the macula, but the physiological adhesion on the nipple requires a longer period of traction. In case of accidental trauma or severe vibration, a crescent-shaped gap in the posterior pole can occur relatively quickly. The two crescents of the crescent are at the bottom of the vitreous body, and the umbilical part of the crescent is equivalent to the posterior pole of the vitreous body, leaving a nipple-sized Turbid ring. This turbid ring indicates the remnants of the glial fibers pulled from the nipple. Sometimes the latter is projected on the ophthalmoscope

Vitreous detachment alone does not necessarily cause retinal detachment. If the patient's original retinal degeneration (cystoid or reticulodegeneration) or old lesions, once localized vitrectomy occurs, it is easy to produce retinal holes and cause retinal detachment. If a blood vessel is ruptured in the diseased area, bleeding can occur. Sometimes retinal detachment may occur first, followed by vitreous degeneration, and the latter's dehydration and contraction in turn will increase the degree of retinal detachment, so the two are clinically very close and very dangerous.

Most of these lesions start from the periphery and are not easily noticed by patients. If the posterior pole vitreous detaches early, macular edema due to traction can affect vision. Continuous traction can lead to serous or even hemorrhagic retinopathy, and macular cystoid degeneration and holes over time. This causes continuous loss of vision or even recovery, so early diagnosis and treatment should be checked.