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Vitreous -  VITREOUS OPACITIES Lecture 5 of 11  NEXT»

1. Opaque sheets anterior to the vitreous

 A. Elschnig pearls after extracapsular cataract extraction or needling (posterior  capsule opacification)
 B. Normal posterior capsule-often following extracapsular cataract extraction or  needling
 C. Soemmerring ring following extracapsular cataract extraction or needling
 D. Vitreous adhesions to iris, capsule, or intraocular lens (IOL) after cataract  extraction with vitreous loss

2. Pseudoglioma-leukokoria (see p. 357)
3. Scattered opacities

 A. Amyloid disease-rare (seen in older persons)
 B. Ankylosing spondylitis
 C. Coagula of the colloid basis of the gel
 D. Crystalline deposits
  (1) Asteroid hyalosis
  (2) Synchysis scintillans
 E. Endophthalmitis
 F. Heterochromic uveitis-in persons 20 to 50 years of age; of all uveitis, iris  atrophy, lens changes
 G. Myeloma, multiple-rare: in persons 50 to 70 years old, associated with bone  pain, anemia
 H. Myopia, severe
 I. Pigment cells-posttraumatic (hemorrhage), senile, or melanotic, associated with  rhegmatogenous retinal detachment.
 J. Protein coagulaplasmoid vitreous
  (1) Choroidal tumors (very rare-reported in metastatic breast cancer once)
  (2) Contusions
  (3) Intermediate uveitis (pars planitis)
  (4) Retinochoroiditis
 K. Red blood cells (see vitreous hemorrhage, p. 424)
 L. Snowball opacities-rare, associated with pars planitis or sarcoidosis,  endophthalmitis (indolent)
 M. Tissue cells-epithelial, histiocytic, glial
 N. Toxoplasmosis-active
 O. Tumor cells-retinoblastoma in older child, reticulum cell sarcoma (older  persons)
 P. Vitreous degeneration-Wagner disease, Ehlers-Danlos syndrome, and Marfan  syndrome, senescent aging changes, myopia
 Q. Whipple disease
 R. White blood cells-inflammatory disease, vitreitis
 S. Retinitis pigmentosa

4. Single opacities

 A. Anterior hyaloid remnant (Mittendorf dot)-25% normal eyes, dot on posterior  lens surface
 B. Hyaloid remnants (uncommon)-persistent hyperplastic primary vitreous
 C. Foreign body-history of trauma or surgery
 D. Dislocated lens (see p. 401)
 E. Parasitic cysts
  (1) Hydatid disease (echinococcosis)-rare, children and young adults,    tropical
  (2) Cysticercosis-rare
 F. Vitreous detachment-common in older or myopic persons

Durant WJ, et al. Vitrectomy and Whipple's disease. Arch Ophthalmol 1984; 102:851.

Hong PH, et al. Vitrectomy for large vitreous opacity in retinitis pigmentosa. Am J Ophthalmol 2001; 131:133-134.

Recchia AE, et al. Endophthalmitis after pediatric strabismus surgery. Arch Ophthalmol 2000; 118:939-944.

Sandgren O, et al. Vitreous amyloidosis associated with homozygosity for the transthyretin methionine gene. Arch Ophthalmol 1990; 108:1586.

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