Posterior Vitreous Detachment / PVD
Simulate posterior vitreous detachment (PVD) — the separation of the
posterior vitreous cortex from the internal limiting membrane (ILM) of
the retina, the single most common vitreoretinal event in human ageing.
The vitreous body is a transparent gel composed of a sparse meshwork of
type II collagen fibrils suspended in a hydrated hyaluronic acid (hyaluronan)
matrix filling the posterior 4/5 of the globe (~4 mL volume). With age,
the vitreous undergoes progressive syneresis (liquefaction) — the
collagen-hyaluronic acid network degrades, collagen fibrils aggregate into
visible strands and sheets, and the gel transitions from a uniform
optically-clear phase into a heterogeneous mixture of liquid vitreous
(lacunae) and collapsed collagen condensations. When the degree of
liquefaction is sufficient, the posterior hyaloid face (posterior vitreous
cortex) separates from the ILM — this is PVD. The separation typically
initiates at the perifoveal macula and propagates anteriorly, with the
final detachment point being the vitreous base (the firm annular
vitreoretinal adhesion 2 mm anterior and 3 mm posterior to the ora
serrata). The pathognomonic clinical sign is the Weiss ring
(Vogt's ring) — a ring-shaped opacity of glial tissue avulsed from the
optic disc margin when the peripapillary vitreous separates, visible as
an annular floater on slit-lamp biomicroscopy and on B-scan ultrasound.
Patients typically present with acute onset of floaters (vitreous
condensations casting shadows on the retina), photopsia (tractional flashes
of light from residual vitreoretinal adhesion points pulling on the retina
during eye movement), and occasionally a curtain/veil sensation if
complicated by retinal detachment. PVD itself is benign in ~85–90% of
cases; however, 10–15% of acute symptomatic PVDs are complicated by
retinal breaks (horseshoe tears at sites of persistent vitreoretinal
adhesion) and 1–3% progress to rhegmatogenous retinal detachment.
Model uncomplicated PVD with floaters and photopsia, PVD with vitreous
haemorrhage, and PVD-associated retinal tear/hole using ΔE colour shift,
CIE xy chromaticity, and image simulation.
Posterior vitreous detachment colour science simulation by Auric Artisan.