Cobwebs

Posterior Vitreous Detachment

• It is a separation of the posterior vitreous cortex from the neurosensory retina - the vitreous collapses anteriorly towards the vitreous base.

• Initially there is liquefaction and syneresis → rupture in the posterior hyaloid → liquified vitreous flows out → separates the posterior hyaloid from the retina

• Begins as a partial PVD at the perifoveal region → progresses to optic disc and formation of Weiss ring

Vitreous traction at firm sites of adhesion → retinal tear → retinal detachment

Risk factors: increasing age, myopes, inflammation, following cataract surgery, trauma

Symptoms: Floaters & Photopsias

Risk of Retinal Tear:

• Acute PVD → 15% risk of retinal tear

• PVD + Presence of vitreous hemorrhage or pigment → 50-70 % risk of retinal tear

• PVD without VH → 10-12% risk of retinal tear

The chance of developing a retinal tear after acute PVD is high and so the patient has to be examined again in 4-6 weeks

Image from Rajan Eye Care Hospital

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