25.
The Role of the Vitreous in the Pathogenesis
of Retinal Diseases
Jörg C. Schmidt, S. Mennel (Marburg)
Background: Due to the immediate neighborhood of vitreous and retina, retinal diseases are
frequently associated with changes of the vitreous.
Material and methods: During the last years, the condition of the vitreous and a posterior vitreous
adherence were diagnosed biomicroscopically, by ultrasound and by OCT. The findings
were then compared with findings during vitrectomy.
Results: In almost all vitrectomies for macular and retinal diseases we found an attached posterior
vitrous intraoperatively, which seemed especially adherent at the posterior pole. This
correlated only partly with preoperative findings, where a posterior vitreous detachment was
described frequently.
Discussion: The literature describes a high percentage of complete posterior vitreous detachment in patients, increasing
with age. In patients that undergo vitreoretinal surgery for macular or retinal diseases, an attached posterior vitreous is
found frequently. We postulate, that this finding, which is untypical for that age group, may be a causative agent for retinal
or vascular disease and prevents a successful treatment of AMD and other diseases because of macular traction. An early
removal of the posterior vitreous may support treatment of these diseases.