David Geffen School of Medicine at UCLA, Los Angeles, CA.
Bascom Palmer Eye Institute, University of Miami Health System, Miami, FL.
Curr Opin Ophthalmol. 2024 Sep 1;35(5):365-368. doi: 10.1097/ICU.0000000000001075. Epub 2024 Jul 11.
Vitreous floaters, characterized by the perception of spots or shadows in the visual field, commonly result from posterior vitreous detachment and can cause chronic symptoms in affected patients. The diagnosis of posterior vitreous detachment is typically determined clinically and can sometimes be confirmed with optical coherence topography (OCT) [1 ▪▪ ] . The objective of this review is to review management options for symptomatic vitreous floaters.
Symptoms of vitreous floaters may be mild or may significantly affect patient quality of life. Observation is the most common management strategy. Procedural management options include pars plana vitrectomy (PPV) and neodymium-doped yttrium aluminium garnet (Nd:YAG) vitreolysis. PPV is considered the most definitive management option for vitreous floaters. PPV, however, carries inherent risks, notably infection, cataract formation, and retinal detachment [2] . Nd:YAG laser vitreolysis is a less invasive alternative with studies demonstrating varied success [1 ▪▪ ,3,4] .
This review provides insights into the current state of knowledge regarding the management of vitreous floaters and can guide clinical decision-making.
玻璃体浮游物的特征是视野中有斑点或阴影的感觉,通常是由于后玻璃体脱离引起的,并可能导致受影响患者的慢性症状。后玻璃体脱离的诊断通常通过临床确定,有时可以通过光学相干断层扫描(OCT)[1▪▪]来确认。本综述的目的是回顾治疗有症状的玻璃体浮游物的选择。
玻璃体浮游物的症状可能较轻,也可能显著影响患者的生活质量。观察是最常见的治疗策略。治疗管理选择包括经睫状体平坦部玻璃体切除术(PPV)和钕掺杂钇铝石榴石(Nd:YAG)玻璃体切除术。PPV 被认为是玻璃体浮游物的最确定的治疗选择。然而,PPV 存在固有的风险,特别是感染、白内障形成和视网膜脱离[2]。Nd:YAG 激光玻璃体切除术是一种侵入性较小的替代方法,研究表明其成功率不同[1▪▪,3,4]。
本综述提供了对玻璃体浮游物管理的当前知识状况的深入了解,并可以指导临床决策。