Congenital vitreous opacity transport management. Treatment of destruction of the vitreous body of the eye. Vitreous opacification - diagnosis, treatment of the disease and prevention

Destruction of the vitreous body, or myodeszopsia, is a serious ophthalmological disease. It is characterized by the appearance of opacity in one of the most important optical structures of the eye, which a person sees as various foreign objects - threads, flies, pointed, granular, powdery, nodular or needle-shaped inclusions. They are sometimes called "floaters" or "floaters." Correct diagnosis is very important for this disease, since such symptoms can accompany other diseases - ophthalmological, neurological, mental. For a pathology such as destruction of the vitreous body, treatment is always complex and specific. In addition, relapses or episodes of incomplete cure often occur, so the disorder should be treated very carefully.

Causes of the pathological condition

The vitreous body is a substance whose structure resembles a gel, filling most of the entire eyeball. It is located in front of the retina and, as it were, supports the lens and other structural elements of the front part of the eye. The basis of its composition is water; it also contains proteoglycans and glycosaminoglycans (carbohydrate-protein structures), including hyaluronic acid. The functions of this optical medium are to give shape to the eye, to ensure its preservation, and to refract incoming light and transmit it directly to the retina. During destructive processes, mainly the light-conducting function is disrupted, which affects the subjective perception of visual stimuli by a person.

Table. Conditions that may be the causes of this pathology.

Destruction of the vitreous body is often the cause or precursor of a much more serious pathology. If among all destruction processes the dominant position is occupied by a change in the consistency of the formation, primarily in the direction of liquefaction, which usually begins from the central part of the formation, then cavities, fibrous fragments, necrotic masses may form in the vitreous body. Inclusions can be filmy, in the form of screeds or adhesions with different densities. All these pathological elements can grow to the bottom of the eye, and this represents a serious problem, because this situation often leads to rupture or rupture.

There are more and less prognostically favorable options for destruction of the vitreous body. The most dangerous process is the process of partial or total wrinkling. This situation is accompanied by deformation and reduction in the volume of the eyeball. In some cases, the retina and vitreoretinal ligaments may rupture, the vitreous body may peel off, and hemorrhages may occur.

Another scenario is vitreous crystallization, in which free-floating white grains appear in the vitreous gel. When moving, they are able to create a picture similar to shiny raindrops.

Symptoms

Destruction of the vitreous body is a disruption of the structure of individual fibers of the formation, as a result of which they become thicker and less transparent. Sometimes several fibers grow together into one conglomerate, intertwining in the form of octopuses, spiders, chromosomes or palm trees. In some cases, the collagen complex breaks down into two parts - a dense and liquid fraction. In this case, lightning flashes before a person’s eyes. This phenomenon, by its nature, is the reaction of the optic nerve to the appearance of empty space, which normally should not exist.

The “rain” that appears before your eyes does not have to be brilliant. Sometimes it takes on a yellowish-golden color. Crystals can have different sizes, shapes (points, balls, plates), colors (from whitish-yellow to dark brown). These small floaters are caused by the appearance of inclusions of crystallized cholesterol, calcium salt, elements such as magnesium and phosphorus. This situation is more typical for older people with atherosclerosis and dyslipidemia, when the metabolism of lipids and cholesterol in the body is disrupted. This condition often accompanies diabetes mellitus.

Foreign objects in the field of vision are best distinguished when looking at a plain, clean surface (bright blue sky, snow cover, light-colored walls or ceiling without a pattern, a sheet of paper, plain bedding) under high-quality lighting. If there is insufficient light, an excess of small details, or a variety of colors, a person may not notice the appearance of “ ” objects before the eyes.

Apart from the presence of extraneous visual images without visual stimuli, there are no other symptoms - the eyes do not hurt, do not water, do not itch, and vision in general usually does not decrease. However, the presence of “flies” can affect the psychological state of the patient - irritate, anger or frighten. People find it difficult to concentrate on small details or painstaking work if objects in front of their eyes move or are too bright.

There is a possibility of confusing these foreign objects with the appearance of “extra” images that appeared for another reason (“dark spots” after holding the gaze in the bright sun, “sparks from the eyes” with a traumatic brain injury or arterial hypertension). Differential diagnostic signs of objects arising due to destruction of the vitreous body are the following:

• with sufficient lighting, they are always visible, regardless of the person’s general condition, blood pressure level, or the presence of a head injury;
• objects are always the same shape and size, color, they can move, but do not disappear or appear again.

Conservative treatment

Conservative therapy for destruction of the vitreous is indicated in cases where there is no threat to vision, the changes are associated with physiological or age-related reasons, and foreign objects in front of the eyes do not cause significant discomfort to the patient. This type of treatment does not bring complete recovery, but it can slow down the development of the disease, the formation of new “visual interference” and improve the general condition of a person.

1. Ethylmorphine. It is applied in the form of drops into the conjunctival sac, causing slight swelling and hyperemia, which are a consequence of improved blood circulation in this area.
2. Taurine ("Tauphon"). A drug that improves metabolism.
3. Methylethylpyridinol (for example, "Emoxipin"). This is a means to protect the vascular wall and improve blood circulation. Used in the form of drops. Pentoxifylline (“Trental”) and dipyridamole (“Curantil”) can be used internally.
4. Statins, fibrates (“Atorvastatin”, “Rosuvastatin”, “Simvastatin”, etc.). Used for atherosclerosis and lipid metabolism disorders.
5. Vitamins. B vitamins are used, as well as vitamin A (retinol) and vitamin C.

Traditional recipes are widespread, but they have no evidence base for either effectiveness or safety, so their use is not recommended.

In the event that conservative treatment is ineffective, or the situation initially does not allow the use of medicinal methods of therapy, surgical methods are used to correct the destruction of the vitreous body - laser intervention or surgical vitrectomy (removal of the vitreous body and replacing it with an artificial one).

Laser vitreolysis

Using a laser beam, inclusions, adhesions, strands or crystals are split into smaller objects that cannot interfere with vision.

For the first time, Frank Fankhauser, the author of several large studies on cataracts and laser treatment of vitreous pathology, spoke about laser vitreolysis. Today, this technique is used by many ophthalmological clinics, since over its history, spanning more than a dozen years, it has confirmed its effectiveness and safety.

Vitreolysis is performed using a special YAG laser technology. It is very important to accurately focus the laser beam; the maximum permissible fluctuation is no more than 6 microns. The laser operating frequency should be from 200 to 600 flashes. Typically, healing takes 1-2 procedures, but can take up to 4.

Considering that pathological inclusions in the vitreous body are often mobile, the complexity of the procedure increases several times in contrast to dissection of the iris or splitting of the posterior capsule of the lens, used for cataracts. Therefore, the procedure is performed only if there is a risk of complications, for example, retinal detachment, destruction reduces the patient’s quality of life or level of vision.

However, despite its complexity, vitreolysis is an outpatient procedure in most cases. Only local anesthesia (drip anesthesia) is used, which does not load the heart muscle, vascular structures, liver, kidneys and other organs.

First of all, the patient receives atropine or similar substances as eye drops: this dilates the pupil and relaxes the ciliary muscle. Then a special lens is placed on the eyeball, allowing the laser beam to be focused strictly on the required area of ​​the vitreous body.

There are no cuts involved, so there is no chance of bleeding. In addition, during the procedure there is no pain, only the sensation of having a lens on the eyes.

Contraindications to vitreolysis:

• violation of the transparency of any optical medium (cataract, edema, corneal opacity);
• a situation where the lens is embedded in the vitreous body;
• violation of hemostasis (blood coagulation system, i.e. increased risk of bleeding);
• retinal detachment.

Video: Laser treatment of vitreous destruction

Complications of the procedure

Among the undesirable consequences recorded:

• increased pressure inside the chambers of the eye;
• microhemorrhages in the choroid;
• retinal reattachment disorder;
• development

However, the benefits of the procedure significantly outweigh the risks of complications.

If laser correction is not possible, microinvasive vitrectomy can be performed.

Minimally invasive vitrectomy

This is a surgical method for correcting the destruction of the vitreous body, in which part of the vitreous body or the entire formation is removed. The main indication for this procedure is retinal detachment, because this method solves several problems at once:

• the need to work on the posterior parts of the eye;
• stopping bleeding;
• correction of retinal detachment;
• extraction of the vitreous body or part thereof;
• replacement of a remote formation with an artificial prosthesis with a certain number of characteristics.

The prosthesis used to replace the vitreous must meet a certain list of requirements:

• absolute transparency;
• strictly specific viscosity indicator;
• hypoallergenic;
• complete absence of toxicity.

Removal of the vitreous can be complete (total) or partial (subtotal). During the procedure, perforation (violation of the integrity) of the eye media is minimal, so the risk of bleeding or complications is low.

For surgery, the patient is usually hospitalized in a hospital, but in some cases the operation is performed on an outpatient basis. Local anesthesia is preferred, but in certain situations combined anesthesia may be required. The surgeon makes several punctures with a very small diameter needle, removes the vitreous body or part of it, and then performs an intervention on the retina - cauterizing it with a laser beam, and then restoring the integrity of the structures and strengthening them. The operation usually does not take more than 3 hours.

Video: Vitriectomy. Last chance for vitreous destruction

Rehabilitation after treatment may require from several days to several weeks. This depends on the amount of work performed, the type of vitreous prosthesis, and also on the condition of the retina.

Thus, destructive changes in the vitreous today can be cured in various ways, both conservative and surgical. An important task is to see a doctor early. Early and correct diagnosis, as well as wisely chosen treatment tactics. If everything is done correctly, the likelihood of recovery, preservation of full vision and absence of relapses is very high.

When looking at a light, well-lit background, you may notice the appearance of floating spots, cobwebs, floaters or clouding. Such figures cannot leave a person indifferent and cause concern. When an ophthalmologist examines the eyeball, the doctor makes a diagnosis: Destruction of the vitreous body «.

What does it mean? Let's try to figure it out.

What kind of disease is this?

Destruction of ST is a disease of the organ of vision that occurs due to a violation of the physicochemical properties of the vitreous substance. With the development of the pathological process, it loses its homogeneous structure. The fibers begin to stick together, become cloudy and move freely in the colloid.

The patient needs to be wary if pathology occurs in the eyes; the cause and treatment are determined by a specialist when examining the patient. Sometimes strands or films form, which leads to serious complications of the organ of vision.

Video:

ICD-10 code

According to the international classification of diseases, destruction of the vitreous body is classified as H43.8– other TS diseases.

Causes

With this pathology, many ophthalmological and general diseases become risk factors. Therefore, when a sick person has spots before his eyes, the causes of the illness can be very different:

• Elderly age

In the central zone of the vitreous body, the rheological properties of the gel deteriorate, and in the peripheral zone, compaction of the colloid is observed.

• Chronic ophthalmological diseases

They can significantly disrupt the integrity of the colloidal substance.

• Pathology of the endocrine system

Diabetes mellitus leads to poor blood circulation in the eye and also causes changes in blood vessels in the retina.

• Diseases of the cardiovascular system

The appearance of atherosclerosis and arterial hypertension provoke disturbances in the ocular and cerebral circulation.

• medium and high degree

Due to changes in the normal shape of the organ of vision, this pathology causes changes in the structures of the eye.

• Various mechanical heads, noses and eyeballs

They cause loss of the homogeneous structure of the vitreous substance. Sometimes, along with destruction, hemorrhage occurs in the CT, which further aggravates the disease.

• General diseases

Pathologies of the liver and kidneys can seriously disrupt the composition of the colloidal substance in the vitreous body.

• Surgery on the organ of vision

During extraction surgery, the integrity of the vitreous may be compromised.

Symptoms

The main manifestation of the disease is considered the appearance of translucent spots before the eyes of any size and shape . Most often they are noticed when looking at light objects or a computer screen. If the patient tries to focus on them, the figures disappear or move.

In addition, patients may experience such complaints:

• Black spots before the eyes: a sign may indicate a detachment of the retina or vitreous;
• The appearance of flashes before the eyes;
• The presence of blood in the vitreous body: in most cases it occurs with injuries, retinal detachment.

There is a small chance that floaters will disappear spontaneously. This happens because they are simply removed from the visible zone. If, after an examination, the ophthalmologist claims that such floaters will not harm your vision, you need to adapt to them and try not to pay attention.

If major damage occurs, specialists may recommend surgery.

Treatment

Destruction of the vitreous body of the eye is treated in several ways:

• Drug therapy;
• Vitreolysis;
• Vitrectomy;
• Traditional methods.

Drugs

With the development of unexpressed pathological processes in the vitreous body, medications that have a therapeutic effect are prescribed:

Vitreolysis

If the vitreous substance is quite severely affected and there is a noticeable decrease in vision, targeted grinding of large collagen particles is performed. For this purpose, a YAG laser is used, which does not cause visual impairment.

Vitrectomy

If the colloidal substance is completely damaged, vitrectomy is performed. It is a microsurgical intervention, the essence of which is to remove the vitreous body. To maintain pressure inside the eye, gas or silicone oil must be injected.

Prevention

When symptoms of the disease appear, a person must be examined by an ophthalmologist, since the pathology can cause adverse effects on the organ of vision: the vitreous body or retina, hemophthalmos, retinal tears, and the development of epiretinal fibrosis. All these complications seriously impair vision or even lead to blindness.

Measures to prevent the disease :

• Timely diagnosis and adequate treatment of eye and general diseases prevents the occurrence of CT destruction. This is why it is recommended to regular examinations from an ophthalmologist and other specialists;
• Maintaining physical activity;
• Carrying out treatment;
• Taking foods rich in vitamins and microelements, or eating special ones.

The destruction of the vitreous body causes a change in the homogeneity of the vitreous substance, which is why we see invisible floaters before our eyes. It is not surprising that a person begins to wonder what it is.

With minor damage, the disease does not cause visual impairment, so only supportive therapy is recommended. If large or total damage to the vitreous collagen occurs, surgical intervention is performed. It eliminates vision impairment and avoids serious vision complications.

There is a clouding of the internal refractive media.

If this occurs in the vitreous, vision may be reduced or remain normal.

This depends on the degree of spread of the pathological process, foci of accumulation of various fractions of substances. This condition should not be tolerated; it develops over time. The sooner therapy begins, the greater the patient’s chances of fully maintaining vision function.

Why does cloudiness occur?

There are many different reasons why vitreous opacities can develop:

• age over 50 years, at which physiological processes associated with the accumulation of various substances occur;
• severe myopia, in which the patient develops vision from -6 diopters;
• inflammatory conditions of the eyeball that develop periodically, becoming chronic;
• diseases spreading to the endocrine glands (hyperthyroidism, diabetes mellitus, pancreatitis);
• temporary disruption of the endocrine background, which occurs during pregnancy, adolescence, menopause, andropause;
• pathological conditions of the microcirculation vessels of the eye, which develop due to systemic diseases (hypertension, atherosclerosis, coronary disease, vascular fragility);
• Excessive strain on the eyes, which occurs with frequent exposure to cramped spaces, prolonged use of a computer and other electronic devices;
• mechanical damage to any parts of the visual organs;
• lack of vitamins and other beneficial substances from food, which leads to hypovitaminosis or vitamin deficiency;
• stress, depression, neuroses, psychoses;
• the effect on the body of infections, viruses, fungi, toxins, especially if pathological processes occur in the organs of vision.

It is not enough for a doctor to simply clear the vitreous body of accumulated substances. He needs to identify the root cause to completely eliminate the risk of recurrence of the condition.

If the patient’s visual acuity has sharply decreased, or clouding occurs in only one or both organs of vision, it is recommended to consult an ophthalmologist. He will conduct several diagnostic tests to make a reliable diagnosis:

• Anamnesis collection. The doctor will ask the patient when vision loss began and whether there were such conditions in the past. The patient may complain of spots before the eyes, multiple opacities that progress over time.
• General inspection. If the pathological condition is at an early stage of development, no symptoms will be visually detected. In the presence of severe clouding of the vitreous body, the accumulated fractions of substances can transfer to the cornea, which causes white spots inside it.
• Visometry. This is a study using diagnostic tables. The more lines the patient sees in them, the better his visual acuity.
• Autorefractometry. This is a test that can be used to determine the refractive ability of the eyeball. The vitreous body refracts rays, transmitting them to the retina. If this structure is broken, the autorefractometer will show this data.
• Ultrasound examination of the eyes. Using the test, you can identify the shape of the eyeball and the condition of the intraocular elements.
• Optical coherence tomography. The patient sits in front of the tomograph and focuses his gaze on the mark. The device scans the organ of vision, producing layer-by-layer image results.
• Fundus examination. The patient is first instilled with Atropine or similar agents that dilate the pupil. The doctor determines the quality of the structural elements; vitreous opacities are always visible through examination.

Based on these data, it is possible not only to identify vitreous opacities, but also other pathological conditions of the eyeballs. Only after making a diagnosis can the doctor begin treatment.

Methods of therapy

The doctor selects the treatment method depending on the severity of the patient’s visual condition. There are several ways in which the eyeball can be treated conservatively. But the doctor can also choose surgical or laser therapy.

Treatment is not always carried out. Often the patient has a partial vitreous opacification that does not develop over time. But such patients need to periodically visit an ophthalmologist to determine the condition of the eyeballs. If the clouding develops and fills all structures, conservative and surgical therapy is necessary.

Conservative therapy includes the following types of drugs:

• medications that normalize the state of microcirculation of the blood vessels of the eyes (Emoxibel, Emoxipin), they are used in small courses to periodically stimulate the blood flow of the eyeball;
• medications that normalize blood circulation in the central nervous system (Cinnarizine), they are prescribed both orally and intravenously; in addition, they promote the resorption of thromboaggregates;
• drugs that prevent the accumulation of insoluble protein fractions in the refractive structure of the eyes (Quinax);
• local vitamin therapy using medicinal drops, which enhance metabolism, leading to increased regenerative capacity (Okovit, Taufon).

Even with the use of conservative therapy, the patient’s condition progresses, the doctor immediately performs surgery to eliminate opacities in the vitreous body:

• Vitreolysis. This is a laser procedure that is aimed at eliminating vitreous opacities. The technique is used for patients who have severe myopia and a high risk of retinal detachment. Anesthetics are first instilled into the patient's eyes. The entire procedure is performed without general anesthesia. Using a laser, areas of accumulation of fractions of various substances are removed. But the technique is applicable only if the clouding does not form strongly and is focally distributed throughout the vitreous body.
• Vitrectomy. This is a major surgical procedure in which the vitreous humor is removed completely or partially. The first option is suitable for those people whose clouding has spread throughout the entire structural element of the eyes. The internal structure of the vitreous body is easily replaced by an artificial environment that fully corresponds to its own element. Partial removal of the vitreous is only suitable if the clouding has developed in a certain area and greatly reduces visual acuity. With partial removal, the doctor does not need to replace the fluid with an artificial medium; it will recover on its own, since the eye medium circulates constantly.

Most often, silicone oil, saline solution, and gas elements are used to replace the structure of the vitreous body.. They are identical in composition and do not form a negative reaction of the immune system, which can lead to an inflammatory condition.

Gradually, the fluid necessary to replace the internal component of the vitreous body is replaced by the eye’s own secretion. This is due to the fact that fluid in the organs of vision constantly circulates. But the effect is observed only when using saline solution or gas bubbles. If the doctor chose silicone oil, the patient will need a second operation after 5 years.

Prevention

There are many different prevention methods that can be used to prevent the formation of cloudiness in the optical media of the eye:

• timely treatment of viral, infectious, fungal diseases of the eyeball;
• timely treatment of systemic diseases that can lead to complications for the eyes, causing visual impairment due to the accumulation of insoluble substances;
• normalization of nutrition, which should include all useful substances, and also reduce the amount of insoluble proteins;
• treatment of endocrine diseases through hormone replacement therapy;
• taking medications prescribed by a doctor;
• In case of mechanical eye damage, consult a doctor and avoid self-medication, which may worsen the situation.

The preventive measures used will not completely eliminate the risk of developing vitreous opacities. This is due to the fact that the pathological condition may be a consequence of the physiological process that forms aging in people after 50 years of age. But the use of preventive measures will significantly reduce the possibility of complications.

Vitreolysis using a YAG laser is a treatment that can reduce or completely eliminate large vitreous floaters.

The presence of vitreous opacities is very common and most do not require any treatment.

The presence of small single fragments in the vitreous cavity is the norm from a medical point of view. However, more severe opacities are often encountered, causing difficulties in reading, driving, and using a computer. For the most part, translucent “ghosts” that appear in the field of vision during, for example, a sharp fall or a parachute jump, lifting weights, or against the background of complete well-being and subsequently discernible when carefully examining light-colored objects are natural lacunae in the vitreous, caused by its design. They sometimes close on their own, move, or form new ones on their own (slowly, over months).

In general, any noticeable “worms” are something in the vitreous that is preventing light from reaching the retina normally. In English-language literature, they are called “floaters” - like specks of dust on the camera matrix. This condition is called “vitreous destruction” (VD).

“Flying midges” and “worms” in the eyes, or where do “dead pixels” come from?

Raise your head and look at something evenly colored in a light background (wall, snow, sky without sun). If something like this suddenly began to slowly float before your eyes:

Get acquainted, this is the destruction of the vitreous body in your eye. For many, such “glitches” appear in childhood and multiply or gradually change over the years. For most people, their presence is not a cause for concern, but their sudden appearance or sharp increase is a reason for an urgent visit to an ophthalmologist. Especially if this is accompanied by lightning before the eyes, a dark veil or fine “tobacco dust”. But to understand the full situation, let’s talk about what this phenomenon is in general and where it comes from.

The eye is a ball, most of which is occupied by the vitreous body (as much as 2/3 of the volume).

It is clearly visible in the diagram above - this is the space between the lens and the retina in the eye cavity. In a normal eye, the vitreous humor is so transparent that when the eye is scanned, it appears empty.

The vitreous body is a jelly-like, transparent, viscous and highly stretchable structure, like jelly or jelly. This “jelly” consists of water, colloids and microelements - collagen fibers, reminiscent of intertwined ropes, soaked in hyaluronic acid. Unlike the cornea, which consists of the same matrix, the density of the filaments in the vitreous body is lower, so the cornea is dense and rigid (by the standards of what is in the eye), but here a viscous medium awaits us. This environment is heterogeneous; there are voids and “cisterns”, various lacunae. The vitreous body is adjacent to the posterior surface of the lens; throughout the rest of its length it is in contact with the retina. A special hyaloid canal passes from the optic disc to the lens through the vitreous body, and the frame of the vitreous body is formed by a thin network of intertwined fibers of various forms of collagen protein. And the gaps are filled with liquid - this structure gives it the appearance of a gelatinous mass. Thanks to the vitreous body, our eyes have the correct spherical shape, it provides incompressibility and ocular tone, absorbs shocks, and nutrients move through the channels. But its light refractive function is very small.

If we need to deliver a medicinal substance to the deep parts of the eye, then we inject it directly into the vitreous cavity with a microneedle, because the eye is a fairly isolated organ from the body as a whole, and not everything that enters the blood reaches the internal contents of the eye.

The vitreous body itself is not attached to the retina along the main area, but is simply adjacent very closely. However, in the macula (the center of the eye, the macula), near the optic nerve and along the equator of the retina there are attachments, and quite strong ones. If, with age, in the event of an injury or the appearance of another disease of the eye and the body as a whole, not just destruction (generally not dangerous), but some blood cells and inflammation appear, this is a very dangerous problem. Everything that gets into such a closed cavity is absorbed for a long time, difficultly and not always completely with a transparent effect. As a rule, stained opacities, rough adhesions and cords remain, reducing visual acuity. This is a terrible picture that can be seen with hemorrhage into the vitreous body (this is called hemophthalmos).

And if droplets of cholesterol accumulate in the vitreous body, it looks like “golden shower”.

What happens as you age?

Somewhere after 30 years, new “midges” often begin to appear, and after 40 years, hyaluronic acid is gradually lost, the transparency of the vitreous body decreases, and visualization of fibers appears. Even later, the vitreous body dries out altogether and begins to peel off from the retina (it simply comes off in places where there is no attachment). Vitreous detachment is a normal sign of aging; it is caused by liquefaction of the vitreous, leading to tension on the retina in areas of strong attachment, which can lead to retinal rupture. Acute vitreous detachment leads to retinal tears in 15% of cases.

“Mid flies” in the eye: so what to do with them?

If, after examination, the doctor finds no damage to the retina in the fundus and only notes the presence of microinclusions in the vitreous, then there is no need to worry - there are no serious risks to vision in this case.
If the patient sees “garbage and midges” that bother him, but knows that there is no danger in this, the issue of dynamic monitoring and getting used to minor shortcomings in the quality of vision is most often discussed. In addition, after a couple of months, patients really stop noticing these inclusions and do not focus their attention on them.
But in some cases, complaints may be due to decreased vision due to “dirty” floating in front of the eye. Then, together with an ophthalmologist, a retina specialist (and not just a doctor in a clinic), the issue of treatment for this condition can be discussed.

There are two options: the first involves the destruction of fragments in the vitreous body using a modern YAG laser (laser vitreolysis), the second involves surgical removal of part of the vitreous body within the optical axis (vitrectomy operation).

Patients are often told that vitrectomy is the only solution, but it is rarely recommended as a standard procedure due to the risk of cataracts and retinal detachment in 2% of cases. Therefore, vitreolysis using a Yag laser provides a number of advantages: it is much safer than vitrectomy, it acts only on opacified areas and not on the entire vitreous body, the procedure is outpatient and lasts only 10-15 minutes, the patient recovers completely within 24 hours.

Conclusion

It is very difficult to judge how much the body actually needs this structure—the vitreous body. It seems possible without it, but its necessity in the structure of the eye has not yet been fully studied. For now, it is intuitively clear that it is better to preserve the vitreous if possible.
A large number of doctors of the last century and the present study the structure of the vitreous body - this is evident from the number of names that are given to its structures (canals, ligaments, etc.).

With age, the vitreous body ages, shrinks, and can cause certain problems. You need to take care of your eyes; if symptoms of vision deterioration appear in any type and age, seek help from the specialists of the Optimed clinic.

Vitreous opacities lead to blurred vision and are usually a manifestation of a systemic disease. It may appear in one or both eyes at once.

The opacities can be small, or they can cover a significant space of the vitreous and tightly attach to the retina.

Functions of the vitreous body

The vitreous body performs a number of important functions: it gives the eye a rounded shape; refracts light passing through the lens to the retina; participates in metabolic processes. Therefore, pathologies such as vitreous opacities or vitreous opacity are very serious and can lead to significant deterioration or complete loss of vision.

Causes

What factors cause this pathology?

• Traumatic eye injuries, including surgical interventions.
• Systemic pathologies (atherosclerosis, diabetes mellitus, arterial hypertension).
• Age-related changes (due to a decrease in metabolic processes in the eye tissues).
• Inflammatory and.
• Taking hormonal drugs.

The vitreous opacities themselves are deposits in fluid pockets that most often form with age-related changes in the eye structures. When light rays pass through, these deposits cast a shadow on the retina, which is perceived by the eye as “flying”.

Often, exudates appear in the vitreous body due to inflammation of the retina and choroid, which also lead to deterioration of vision. Such opacities consist of cellular elements (leukocytes and lymphocytes), accumulating first on the back surface of the lens, and then in the thickness of the vitreous body (when voids appear in it). These exudates often resolve on their own (partially or completely) after the inflammation in the retina and choroid decreases.

Also, opacities of the vitreous body are determined during destruction, then they are presented in the form of flakes, stripes and threads. It is usually observed in severe forms of hypertension, traumatic injuries, and eye tumors.

In atherosclerosis, opacities are represented by accumulations of cholesterine crystals. This phenomenon is observed in the elderly and patients with diabetes.

Clinical symptoms

The patient's complaints are associated with the appearance of “flying spots” before the eyes, which can have different sizes and shapes (in the form of round spots, curved threads, etc.). In each specific case, the size and number of “flies” are individual, it depends on the cause and severity of the pathology.

As a rule, when the eyeball moves, these opacities move with it, which is why they are called floating. Floaters are best seen when looking at light-colored surfaces in bright light.

Diagnostics

The diagnosis is made after an examination based on characteristic clinical symptoms, and medical history data (the presence of concomitant pathologies) are also taken into account.

It is necessary to distinguish age-related changes from inflammatory pathologies of the vascular tract and retina, for which examination is carried out using a slit lamp.

Therapy

The effectiveness of treatment depends on the treatment of the systemic disease that provoked the vitreous opacification.

Symptomatic, absorbable, anti-inflammatory and physiotherapeutic treatment is carried out. Surgery () is indicated only for severe forms of pathology.

In some cases (for example, with inflammatory processes of the retina and choroid, some systemic diseases), vitreous opacities can resolve on their own, if not completely, then to the extent that they no longer bother the patient. However, this does not mean that you can neglect visiting an ophthalmologist if any symptoms appear.

Only the doctor decides whether it is possible to dynamically monitor the course of the pathology or whether any medical interventions are necessary.

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