Perichon J Y, Brasseur G, Uzzan J
Service d'Ophthalmologie, C.H.R.U. Charles Nicolle, Rouen.
J Fr Ophtalmol. 1993;16(10):538-44.
Vitreoretinal relationships can be evaluated by biomicroscopic examination and ultrasound. We analyzed 220 normal and emmetropic eyes in a population between the ages of 20 to 80 years to evaluate the position of the posterior vitreous surface (prospective study). We found that: Most cases of very partial and very peripheral P.V.D. (71/220 eyes; 32%), especially those confined to the nasal quadrant (50/71 eyes), corresponded to a simple increase of reflectivity of the vitreous base rather to than real PVD. Twenty-five per cent of the patients over the age of 80 years did not have PVD. The frequency of partial PVD located in 2, 3 and 4 quadrants except the posterior pole was very low, regardless of age. These partial PVD are transient. Fifty-eight per cent of the patients over the age of 80 years had a complete PVD. This percentage is clearly lower than that reported by most of the large biomicroscopic studies. The extension of PVD always begins at the vitreous base and ends at the posterior pole. This extension occurs around the age of 60-65 years and results, in most cases (35/38 eyes; 92%), in complete PVD with collapse. A prepapillary ring is a specific sign of complete PVD with or without collapse, but its absence (5/38 eyes) does not indicate the absence of PVD. The frequency of giant lacune is maximal (16/32 eyes; 50%) for young people between the ages of 30 and 40 years, then decreases as PVD becomes complete. The average level of reflectivity of the vitreous body is highest for patients between the ages of 70 and 80 years, but this variation is only very slight. This study also stresses the clinical criteria used to make the ultrasonic differential diagnosis between PVD and giant lacunae.
玻璃体视网膜关系可通过生物显微镜检查和超声进行评估。我们对年龄在20至80岁之间的人群中的220只正常和正视眼进行了分析,以评估玻璃体后表面的位置(前瞻性研究)。我们发现:大多数非常局部和非常周边的玻璃体后脱离病例(71/220只眼;32%),尤其是那些局限于鼻侧象限的病例(50/71只眼),对应于玻璃体基底部反射率的单纯增加,而非真正的玻璃体后脱离。80岁以上的患者中有25%没有玻璃体后脱离。除后极外,位于2、3和4象限的部分玻璃体后脱离的发生率非常低,与年龄无关。这些部分玻璃体后脱离是短暂的。80岁以上的患者中有58%发生了完全性玻璃体后脱离。这一百分比明显低于大多数大型生物显微镜研究报告的百分比。玻璃体后脱离的扩展总是始于玻璃体基底部,止于后极。这种扩展发生在60 - 65岁左右,在大多数情况下(35/38只眼;92%)会导致伴有塌陷的完全性玻璃体后脱离。视乳头前环是伴有或不伴有塌陷的完全性玻璃体后脱离的一个特异性体征,但其缺失(5/38只眼)并不表明没有玻璃体后脱离。巨大腔隙在30至40岁的年轻人中发生率最高(16/32只眼;50%),然后随着玻璃体后脱离变得完全而降低。玻璃体的平均反射率水平在70至80岁的患者中最高,但这种变化非常轻微。本研究还强调了用于对玻璃体后脱离和巨大腔隙进行超声鉴别诊断的临床标准。