Purpose: To evaluate the degenerative findings including cistern formation in the premacular vitreous using optical coherence tomography.
Methods: A novel enhanced vitreous imaging method by which four A-scans at each position were averaged before the Fourier transform increased the image quality per frame so that subsequent image registration for averaging could occur. Analysis of B-scans and volume-rendered images of eyes in subjects of various ages was performed.
Results: There were 43 eyes of 23 subjects ranging in age from 23 to 68 years. The texture in the vitreous images suggests specific orientations of the vitreous fibers in the macular region; there were fibers circumferential to the retina immediately anterior to the premacular bursa. The pattern of the vitreous fibers seemed less well-defined internal to the zone of circumferential fibers. In younger eyes, there were striations oriented in a roughly inferior to superior direction in this zone. In older eyes, there were striations in the same orientation but actually were alternating zones of vitreous synchysis and syneresis. In these same eyes, numerous cisterns appeared at various levels in the vitreous gel. With extensive vitreous condensation and synchysis, definition of the premacular bursa was lost.
Conclusion: With this novel method of enhanced vitreous imaging, the vitreous seemed to have stereotypic patterns of degeneration. The formation of vitreous syneresis and synchysis may be related to organization architecture of the vitreous, including the pattern of vitreous collagen deposition, and the effects of eye motion through decades of time.
Spaide RF, Valmaggia P, Maloca PM, Scholl HPN, Otto TP, Caujolle S. Imaging the vitreous with a Novel Boosted Optical Coherence Tomography Technique: Vitreous Degeneration and Cisterns. Retina. 2022;42:1433-1441. https://pubmed.ncbi.nlm.nih.gov/35333841/