Vitreous Cyst
Vitreous cysts can be congenital or acquired.
Congenital Cysts:
Remnants of the hyaloid vascular system
Located at hyaloid canal and found in conjunction with a Mittendorf's dot or Bergmeister's papillae.
Stable, do not progress and rarely interfere with visual acuity.
Non-pigmented pearl-gray cysts with a smooth surface, can be sessile or pedunculated.
Located anterior to the optic disc.
Some can be limited in movement due to vitreous strands attaching the cyst to the optic disc.
Acquired Cysts:
Usually occur secondary to or associated with:
Ocular trauma.
Intraocular inflammation/infection/ uveitis eg. Intermediate Uveitis, Toxoplasmosis.
Retinal diseases such as Retinitis pigmentosa, Choroidal atrophy, Retinoschisis, High myopia with uveal coloboma etc.
Retinal detachment surgeries
Symptomatic and associated with a reduction in visual acuity.
Trauma can cause damage to the pigment epithelium of ciliary body and create pigment cysts.
PATHOLOGY:
Congenital cysts are choristomas (normal tissues growing in abnormal location) of the primary hyaloidal system.
Derived from the pigment epithelium of the iris or ciliary body.
Contains immature melanosomes.
INVESTIGATIONS:
B Scan Ultrasound to look for scolex in case of cysticercosis.
OCT can also help characterize the cyst.
UBM to rule out anomalies of ciliary body or posterior iris.
Fluorescein angiography – assists in characterization of intra and extra cystic vascularization.
MANAGEMENT:
Asymptomatic cysts: Observation and follow-up
Symptomatic cysts:
Laser cystotomy by Argon laser or Nd:Yag laser.
Pars plana vitrectomy with cyst excision.
www.ophthalmobytes.com
Image from Rajan Eye Care Hospital
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