Optometry Continuing Education

Posterior Vitreous Detachment

    • CE credits 2 hours
    • COPE code 52180-PS / 113752
    • Available until Mar 21, 2020
    • $29

Introduction

Objectives

  • To review the pathophysiology, diagnosis, and management of posterior vitreous detachment
  • To better understand when to refer a patient with a complicated PVD
  • To know how to counsel a patient with PVD
  • To review associated vitreoretinal interface diseases
  • To review the statistical concept of likelihood ratio with relevance to patients presenting with acute posterior vitreous detachment

Case

A 67 year old female presents to your clinic with the complaint of flashing lights and a “squiggly line” in her right eye over the last 48 hours. She says the symptoms first started when she was gardening, and she originally thought she had a piece of dirt on her glasses. There are no headaches associated with the symptoms, and she is otherwise healthy.

On exam, best corrected visual acuities are 20/20 OU. Pupils and intraocular pressures are normal. On dilated fundus examination, a vitreous opacity is evident overlying the optic nerve head of the right eye.

Quick Question

What is the risk of a retinal tear or hole in the setting of an acute posterior vitreous detachment?

  • <1%
  • 5%
  • 14%
    CORRECT

    The prevalence of a retinal break in the setting of acute PVD is 14%.

  • 30%

Introduction

Posterior vitreous detachment (PVD) is a common age-related phenomenon characterized by dehiscence of the posterior vitreous cortex from the internal limiting membrane of the retina in conjunction with vitreous liquefaction.1 It often results in symptoms of flashes and/or floaters, and can be asymptomatic. Males and females are affected equally.2

The prevalence of PVD increases with age. While rare before the age of 50, it is present in over 60% of individuals over the age of 70.3 PVD mostly occurs without significant sequelae, but can result in a variety of retinal problems including retinal breaks, retinal detachment, and others.

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