Optical Coherence Tomography for Diagnosis of Posterior Vitreous Detachment at the Macular Region

PURPOSE: To assess optical coherence tomography (OCT) for diagnosing posterior vitreous detachment (PVD) at the macular region compared to kinetic B-scan ultrasonography. METHODS: In the present study, the authors prospectively investigated the frequency of PVD at the posterior pole utilizing ocular kinetic B-mode sonography in 315 eyes of 188 patients (113 female, 75 male; mean age, 72.8 years; range, 39-94) prior to cataract surgery. In addition, OCT scans of the macular region were performed in all subjects for detection of PVD at the macula. RESULTS: A total of 130 eyes (41.3%) had no sonographic signs of PVD. In this subset of patients in 36 eyes (27.7%), OCT revealed a flat PVD at the macular region with the distance between the posterior hyaloid and retinal surface being less than 400 microm (mean distance, 234 +/- 112 microm, range, 24-398). When combining both methods, the diagnosis of PVD at the posterior pole was made in 221 of 315 eyes (70.2%). CONCLUSIONS: OCT is a valuable tool for detecting PVD at the macular region, particularly in cases with small distances between the retinal surface and posterior hyaloid. Proof of attachment of the posterior hyaloid can be established only by combining kinetic ultrasonography and OCT.