What are the other Names for this Condition? (Also known as/Synonyms)

• Posterior Hyaloid Detachment
• PVD (Posterior Vitreous Detachment)
• Vitreous Detachment, Posterior Aspect

What is Posterior Vitreous Detachment? (Definition/Background Information)

• Posterior Vitreous Detachment (PVD) is a common, age-related condition that involves the gel-like substance that makes up the majority of the inside of the eye, called the vitreous fluid, detaching from the retina. As the vitreous liquefies due to aging, it usually and eventually detaches itself from the retina
• Over time, usually within the seventh decade of the lifespan, the vitreous fluid begins to liquefy (due to a variety of reasons), which makes the attachment of the vitreous to the retina weaker
• This can cause retinal detachment and appearance of eye floaters. In rare cases, the signs and symptoms of Posterior Vitreous Detachment may also include reduced vision
• Generally, Posterior Vitreous Detachment does not require medical intervention unless certain complications are seen to arise, such as retinal detachment and vitreous hemorrhages, which are typically associated with symptoms that include flashes and floaters
• Consultation with an ophthalmologist may be necessary if sudden and ‘scary’ symptoms, such as eye flashes and floaters, are encountered. The prognosis of Posterior Vitreous Detachment is good in a majority of the individuals, as it is usually not a ‘vision-threatening’ condition

Who gets Posterior Vitreous Detachment? (Age and Sex Distribution)

• Posterior Vitreous Detachment usually starts to occur in middle-aged and elderly adults. By age 65, about 65% of all individuals experience PVD. By age 75, about 75% of all individuals are known to experience it
• A partial Posterior Vitreous Detachment may occur in as much as 50% of all individuals in their sixth decade. A partial PVD may turn into a total or complete PVD by the seventh and eighth decade
• Both males and females may experience the condition. However, it is slightly more common in females than in males
• No racial/ethnic predilection or geographical restriction is noted

What are the Risk Factors for Posterior Vitreous Detachment? (Predisposing Factors)

The risk factors for Posterior Vitreous Detachment include:

• Advanced aging is a key risk factor
• Longstanding myopia (or nearsightedness): Myopia may significantly have an impact on how early a PVD starts to occur. Myopia can actually cause an increase in the axial length of the eye (stretching of the eye) over time, which causes traction on the back of the eye where the vitreous is attached to the retina. This traction can eventually lead to an earlier disruption or detachment of the vitreous
• Uncontrolled diabetes
• Trauma to the head or eye region
• Intraocular hemorrhage or inflammation due to a variety of reasons

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one's chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Posterior Vitreous Detachment? (Etiology)

Posterior Vitreous Detachment results in the liquefaction of the vitreous fluid over a period of time, typically due to aging. The vitreous fluid is a gel-like semi-solid structure that is in close contact with the retina.

The causal factors of Posterior Vitreous Detachment may include:

• Natural disruption of the hyaluronic acid-collagen complex
• Liquefaction of the gel-like vitreous fluid
• Contraction of collagen fibers that have broken-off from the gel-like vitreous

What are the Signs and Symptoms of Posterior Vitreous Detachment?

In mild cases of Posterior Vitreous Detachment, there may not be any signs and symptoms. In some rare cases, the following may be observed:

• Increase in number and frequency of floaters
• Flashes of light in vision of affected eye
• Decreased vision (rare)

How is Posterior Vitreous Detachment Diagnosed?

Posterior Vitreous is diagnosed using the following methods:

• A complete physical examination (including eye examination) with medical history evaluation
• Fundal examination by an eye specialist (retina specialist): Observation of a specific vitreous opacity, called a Weiss ring, located anterior to the optic nerve head upon fundus examination
• Optical coherence tomography (OCT) is an imaging technique that helps visualize the eye structure. This tool provides 3-dimensional images of soft biological tissues such as the retina, optic nerve, arteries, etc.

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Posterior Vitreous Detachment?

Complications due to Posterior Vitreous Detachment may include:

• Retinal break (retinal tear or retinal hole)
• Macular hole
• Epiretinal membrane
• Vitreomacular traction

All of the above complications can affect or alter an individual’s vision.

How is Posterior Vitreous Detachment Treated?

Generally, no treatment is required for Posterior Vitreous Detachment, when the signs and symptoms are mild or insignificant. Treatment is administered, if it is associated with any complications such as the following:

• Retinal tear: Laser barrage or cryo treatment of retinal tear or hole is undertaken
• Retinal detachment: Treatment of retinal detachment, if retinal tear or hole leads to the detachment of the retina
• Formation of macular hole: Surgical repair of the macular hole
• Formation of epiretinal membrane: Surgical peeling of epiretinal membrane if it is affecting vision

In severe cases, a complete removal of the vitreous fluid using a surgical procedure known as a vitrectomy is undertaken.

How can Posterior Vitreous Detachment be Prevented?

• Currently, there are no specific methods or guidelines to prevent Posterior Vitreous Detachment in a majority of cases, as it is an age-related condition
• Avoiding blunt ocular trauma can help in preventing acute PVD, which is usually associated with complications

What is the Prognosis of Posterior Vitreous Detachment? (Outcomes/Resolutions)

The prognosis of Posterior Vitreous Detachment (PVD) is generally good, as it normally does not affect one’s vision.

• A majority of individuals who develop eye floaters get better with suitable treatment
• However, in about 10-15% of the individuals who experience an acute onset of PVD, a retinal break/tear may be experienced. This should be treated as soon as possible to prevent retinal detachment

Additional and Relevant Useful Information for Posterior Vitreous Detachment:

• If one experiences an increased number or frequency of floaters, or any flashes of light in one’s vision, it is important to check with an eye healthcare professional as soon as possible for a definitive diagnosis and to rule out a retinal break or retinal detachment
• Although a Posterior Vitreous Detachment is the most likely cause of increased floaters or flashes of light, they can also be the symptoms of a retinal break or detachment, which is why an immediate and thorough fundus examination is crucial to prevent possible vision loss