This report set out to describe the anatomical relationships between retinal neovascular complexes (NVC), the posterior vitreous, and the vitreoretinal interface in patients with proliferative diabetic retinopathy using spectral domain OCT. The following was recorded for each NVC 1) posterior hyaloid face status (attached, detached, tethered to NVC), 2) the presence of vitreoschisis, and 3) the presence or absence of panretinal laser photocoagulation (PRP) scars. Seventy-seven NVCs (51 eyes) were evaluated, 35 of whom had visible PRP scars. Morphologic classification of all 77 NVCs showed that 36 (47%) were flat, 13 (17%) were forward, and 28 (36%) were table-top. Epiretinal membrane was seen in 23 of 77 (30%) scans; 61 (79%) had grown along the outer surface of the posterior hyaloid face, and vitreoschisis was present in 37 (48%). The ‘wolf’s jaw’ configuration was present in 9% and resulted from NVC arising from the arcades and proliferating along the posterior hyaloid face. By contrast, NVCs that invaded the bursa originated from smaller venous tributaries more distant from the arcades. The premacular bursa and prevascular vitreous fissure/perimacular cistern were invaded infrequently, respectively, in 15% and 38% (P=0.137). They found that the posterior hyaloid face was attached in most of the scans in this cohort and that, among these, approximately 48% exhibited vitreoschisis, a higher prevalence than that reported by ultrasound but not as high as definitive histopathology. 

Tomographic relationships between retinal neovascularization and the posterior vitreous in proliferative diabetic retinopathy.
Vaz-Pereira S, Dansingani KK, Chen KC, et al.
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Saruban Pasu

Moorfields Eye Hospital, London, UK.

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