Bamonte Giulio, Iodice Clemente Maria, Mastropasqua Rodolfo, Van Dijk Elon H C, Appeltans Andrea, Cicinelli Maria Vittoria, Menean Matteo, Ten Tusscher Marcel, Harmer Stuart W, Marolo Paola, Borrelli Enrico, Reibaldi Michele, Panos Georgios D, Motta Lorenzo
Department of Ophthalmology, Brussels University Hospital, Av. du Laerbeek 101, 1090 Jette, Belgium.
Department of Ophthalmology, HagaZiekenhuis, Els Borst-Eilersplein 275, 2545 AA The Hague, The Netherlands.
J Clin Med. 2024 Oct 11;13(20):6052. doi: 10.3390/jcm13206052.
To assess the mismatch between the clinical observation of vitreous alterations and self-reported symptoms in young patients complaining of symptomatic vitreous opacities (SVO). The ophthalmic medical records of young patients presenting primarily with SVO were retrospectively evaluated. Symptoms severity was assessed using a questionnaire. The status of the vitreous body was examined with indirect ophthalmoscopy at the slit-lamp and classified according to an ad hoc severity scale. Sixty eyes of thirty otherwise healthy patients (median age: 32.5 (IQR: 29.0-37.0) years old) complaining of SVO (median duration: 38 months; interquartile range: 18-84 months) were enrolled. SVO was rated as severe by 50% of participants, affecting all the activities explored in the questionnaire. Twenty-three patients (76.6%) reported SVO-related depression and/or anxiety, for which eleven patients (36.6%) were or had been using medication. Fifty-eight eyes (96.6%) showed no evidence of (or minimal) vitreous opacity, while two eyes (3.3%) were found to have significant vitreous opacity. No significant inter-gender differences ( > 0.05) and no significant differences ( > 0.05) were found between the severity of vitreous opacity and patients' reported symptoms nor with their psychological status and medication use. Severe discomfort related to the perception of vitreous floaters exists in young patients whose vitreous gel examination is unremarkable or shows only minor alterations. We believe this discrepancy can be explained by optical anisotropy; significant forward-scattering of light, which results in floater symptoms; and reduced back reflection, which limits the clinical observation.
评估有症状性玻璃体混浊（SVO）的年轻患者中玻璃体改变的临床观察结果与自我报告症状之间的不匹配情况。对主要表现为SVO的年轻患者的眼科病历进行回顾性评估。使用问卷评估症状严重程度。在裂隙灯显微镜下用间接检眼镜检查玻璃体状态，并根据特设的严重程度量表进行分类。纳入了30名其他方面健康的患者（中位年龄：32.5岁（四分位间距：29.0 - 37.0岁））的60只眼睛，这些患者主诉有SVO（中位病程：38个月；四分位间距：18 - 84个月）。50%的参与者将SVO评为严重，影响了问卷中探索的所有活动。23名患者（76.6%）报告有与SVO相关的抑郁和/或焦虑，其中11名患者（36.6%）正在或曾经使用药物治疗。58只眼睛（96.6%）未显示（或仅有轻微）玻璃体混浊迹象，而2只眼睛（3.3%）被发现有明显的玻璃体混浊。在玻璃体混浊的严重程度与患者报告的症状之间，以及与他们的心理状态和药物使用情况之间，未发现显著的性别差异（P>0.05）和显著差异（P>0.05）。在玻璃体凝胶检查无明显异常或仅显示轻微改变的年轻患者中，存在与玻璃体漂浮物感知相关的严重不适。我们认为这种差异可以用光各向异性来解释；光的显著前向散射导致漂浮物症状；以及向后反射减少，这限制了临床观察。
