A New Classification of Vitreous Base Avulsion

Objective: Redefinition and classification of vitreous base avulsion (VBA) adapt to the clinical need for diagnosis and treatment of it. Design: A retrospective consecutive case observation. Participants: Ninety-eight consecutive patients (98 eyes) with VBA included 23 patients with closed-globe injury, 46 with open-globe injury, 17 with rhegmatogenous retinal detachment, 6 with proliferative diabetic retinopathy, 4 with vitreous hemorrhage caused by miscellaneous diseases, and 2 with acute retinal necrosis syndrome. Methods: The ora serrata and the pars plana were examined carefully using a slit-lamp biomicroscopy combining with depressing Goldmann three-mirror lens before operation and observed under the surgical microscope with scleral indentation during the scleral buckling or vitrectomy surgery. The samples obtained from the operations were examined histopathologically. Main outcome measures: The VBA was classified into the acute and the chronic according to the happening times and was subdivided into two subtypes of surgery and eye trauma based on the causes. The acute VBA was defined that the avulsion concurred at the same time of trauma and surgery, and the chronic that was occurred after one month of open-globe injury and surgery. Results: The VBA was acute traumatic in 24 cases, acute intraoperative in 64 cases, chronic posttraumatic in 8 cases and chronic postoperative in 2 cases. The histopathology presented that a sheet of the nonpigmented epithelium linked to the peripheral retina in all specimens of acute traumatic and intraoperative VBA, but that the pigmented epithelium was found in the some cases. The samples of chronic posttraumatic and postoperative VBA were similar in the morphology, in which the retina, ciliary epithelia and proliferative fibrous tissues could be detected. Conclusions: The clinical manifestations of VBA can be divided into two types as acuteness and chronicity and two subtypes as trauma and surgery. They are all attributed to an acute or chronic vitreous traction on the vitreous base. It is most common in the cases of eye trauma, vitreous surgery and cataract surgery with vitreous loss. [Wen Liu, Shan Xue, Peng Chen, Yan-Qing Gao, Meng Ping Chen, Yan Li Ji. A New Classification of Vitreous Base Avulsion. Life Sci J 2014;11(9):51-56]. (ISSN:1097-8135). http://www.lifesciencesite.com. 8