Asteroid hyalosis: clinical review of 58 cases

Eye, 2008

Asteroid hyalosis (AH) is a common degenerative process in which fatty calcium globules collect within the vitreous humour. The condition rarely causes visual disturbances, and surgical removal is only rarely required. The presence of AH has been associated with systemic diseases such as diabetes; however, research in this area has been hampered by the lack of an animal model of AH. Recently, we have reported that AH occurs in galactose-fed beagles that develop the advanced stages of diabetes-like retinopathy. Comparisons of vitreous humour containing asteroid bodies (ABs) collected from these galactose-fed beagles and vitreous samples from age-matched normal beagles without ABs indicate that ABs contain calcium and phosphorous. Subtraction analysis of chloroform extracts of the vitreous samples by electrospray mass spectroscopy resulted in the identification of the quasimolecular ion of 1,2dipalmitoyl-glycero-3-phosphoethanolamine (DPPE) as the main component of ABs. Since several reports indicate that ABs are composed of lipid-calcium complexes, we have proposed that the main component of ABs in the galactose-fed dogs with AH is a quasimolecular ion of DPPE in which two molecules of DPPE are complexed through their phosphates groups with calcium. We suggest that these lipid components diffuse into the vitreous from the degenerating retinas of these dogs.

Retina, 2006

Purpose-To demonstrate the clinical utility of OCT (optical coherence tomography) in diagnosing macular structural abnormalities in patients with asteroid hyalosis.

PURPOSE To compare the visual outcomes in both eyes of patients who undergo phacoemulsification and trifocal intraocular lens (IOL) implantation and have asteroid hyalosis (AH) or synchysis scintillans (SS) in only 1 eye. METHODS This retrospective comparative cases series study evaluated uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected intermediate visual acuity (UIVA), uncorrected near visual acuity (UNVA), predictability, safety, efficacy, and satisfaction after implantation of the same model of trifocal IOL in both eyes (PhysIOL FineVision Pod-F and Micro-F and Rayner RayOne Trifocal). RESULTS A total of 164 eyes from 82 patients (41 females, 50%) met the inclusion criteria. There were no statistically significant differences in sphere, cylinder, spherical equivalent, UDVA, UIVA, and UNVA between the groups. Postoperative CDVA was slightly better in the control group (logMAR 0.03) than in the AH/SS group (logMAR 0.04) (p: 0.014). Th...

Ophthalmology

Purpose: Despite posterior vitreous detachment being a common ocular event affecting most individuals in an aging population, there is little consensus regarding its precise anatomic definition. We investigated the morphologic appearance and molecular composition of the posterior hyaloid membrane to determine whether the structure clinically observed enveloping the posterior vitreous surface after posterior vitreous detachment is a true basement membrane and to postulate its origin. Understanding the relationship between the vitreous (in both its attached and detached state) and the internal limiting membrane of the retina is essential to understanding the cause of rhegmatogenous retinal detachment and vitreoretinal interface disorders, as well as potential future prophylactic and treatment strategies. Design: Clinicohistologic correlation study. Participants: Thirty-six human donor globes. Methods: Vitreous bodies identified to have posterior vitreous detachment were examined with phasecontrast microscopy and confocal microscopy after immunohistochemically staining for collagen IV basement membrane markers, in addition to extracellular proteins that characterize the vitreoretinal junction (fibronectin, laminin) and vitreous gel (opticin) markers. The posterior retina similarly was stained to evaluate the internal limiting membrane. Findings were correlated to the clinical appearance of the posterior hyaloid membrane observed during slit-lamp biomicroscopy after posterior vitreous detachment and compared with previously published studies. Main Outcome Measures: Morphologic appearance and molecular composition of the posterior hyaloid membrane. Results: Phase-contrast microscopy consistently identified a creased and distinct glassy membranous sheet enveloping the posterior vitreous surface, correlating closely with the posterior hyaloid membrane observed during slit-lamp biomicroscopy in patients with posterior vitreous detachment. Immunofluorescent confocal micrographs demonstrated the enveloping membranous structure identified on phase-contrast microscopy to show positive stain results for type IV collagen. Immunofluorescence of the residual intact internal limiting membrane on the retinal surface also showed positive stain results for type IV collagen. Conclusions: The results of this study provide immunohistochemical evidence that the posterior hyaloid membrane is a true basement membrane enveloping the posterior hyaloid surface. Because this membranous structure is observed only after posterior vitreous detachment, the results of this study indicate that it forms part of the internal limiting membrane when the vitreous is in its attached state.

2009

To compare laser interferometry (LI) and ultrasound A-scan in measurement of axial length (AL) in eyes with asteroid hyalosis Methods: Twenty three patients with unilateral moderate to severe asteroid hyalosis determined by B-scan ultrasonography images participated in the study. The AL measurements were obtained by LI and ultrasound A-scan in both asteroid hyalosis and noninvolved eyes. The measurements were performed by the two methods as well as for affected and contralateral normal eyes and were statistically compared using the paired T-test. A P-value less than 0.05 was considered significant. Results: The ultrasound AL measurements were taken in every case but measurement with the LI method was not possible in 4 eyes with asteroid hyalosis (17.3%). There was a high correlation between LI and ultrasound A-scan measurements in both asteroid hyalosis and noninvolved eyes (r 2 =0.97, P<0.001 and r 2 =0.95, P<0.001 respectively). There was no significant difference between AL taken by either method in asteroid hyalosis and noninvolved eyes. Conclusion: The failure rate of AL measurement using LI was relatively high in eyes with asteroid hyalosis. There was a high correlation between AL measured by ultrasound A-scan and LI method in both asteroid hyalosis and noninvolved eyes.

Journal of Ophthalmic & Vision Research, 2010

A 64-year-old diabetic lady underwent pars plana vitrectomy in her left eye for a taut posterior hyaloid face due to proliferative diabetic retinopathy (PDR). Visual acuity (VA) at baseline had been 20/120. She had previously received panretinal laser photocoagulation (PRP) and the retinopathy had been stable, but there was localized extrafoveal tractional retinal detachment in the inferonasal quadrant. After vitrectomy, she was discharged in good condition, VA of 20/400 and mild vitreous hemorrhage (VH). One month postoperatively, the density of the VH increased and VA decreased to counting fingers (CF) (Fig. 1). The VH was non-clearing for three months but on echography, the retina was attached (Fig. 2). VH density decreased one month later and the patient received additional peripheral laser therapy. Six months postoperatively, she underwent uncomplicated phacoemulsification with intraocular lens (IOL) implantation due to severe lens opacity. One month after cataract surgery, VA ...

Scholars Academic Journal of Pharmacy

Asteroid hyalosis is a rare degenerative vitreous disease and it is generally asymptomatic. Its etiology is still unknown. We report a case of asteroid hyalosis in a 59-year-old diabetic patient with peripheral neuropathy related to POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy, M component protein, skin changes). The aim of this work is to report the unusual association of asteroid hyalopathy with POEMS syndrome.

To investigate the prevalence of scleral hyaline plaque among older adults in the city of Niterói in southeastern Brazil. A second goal was to assess the correlation between scleral hyaline plaque and several age-related diseases, including eye diseases and systemic diseases. Methods: The study sample comprised 667 participants who were followed for 15 months. The study had a prospective, longitudinal, observational design that established inclusion and exclusion criteria. The following variables were selected for correlation with scleral hyaline plaque: sex, age, age range, iris color, ethnicity, presence of cataract, moderate to high myopia, age-related macular degeneration (AMD), diabetes mellitus, systemic arterial hypertension, degenerative arthritis, and osteoporosis. These correlations were assessed by means of the χ 2 test and Student's t-test. Multivariate analysis was performed to exclude factors that were potentially associated with aging exclusively but that did not have a direct relationship with hyaline plaque. Binary logistic regression was used to calculate odds ratios, significance, and confidence intervals. Results: Scleral hyaline plaques were found in 177 patients (17.54%). There was a statistically significant association between the presence of hyaline plaques and sex (female), age range (70 years old), ethnicity (Caucasian), cataract, moderate to high myopia, systemic arterial hypertension, degenerative arthritis, and osteoporosis (P0.05). On multivariate binary logistic regression analysis, only female sex, age range (70 years), moderate to high myopia, and degenerative arthritis exhibited significant correlation. Conclusion: The prevalence of scleral hyaline plaque in the present study was higher than in previous reports in the medical literature. Several age-related diseases exhibited a correlation with scleral hyaline plaque. The most significant factors associated with scleral hyaline plaque were advanced age, female sex, moderate to high myopia, and degenerative arthritis.

2018

BMC Ophthalmology, 2018

Background: Keratoconus (KC) is a multifactorial, degenerative ectatic condition of the cornea. It usually manifests during late adolescence or the early twenties. A painless disease, KC may end with severe visual loss. The prevalence of KC in middle-eastern countries is much higher than in other regions of the world. This may be due to genetic and environmental risk factors and consanguinity. The goal of this study is to explore the demographic profile of Palestinian keratoconic patients. Methods: A retrospective study was conducted in two ophthalmology centres (Tertiary Ophthalmic Centre of An-Najah National University Hospital and An-Noor Centre at the Specialized Arab Hospital). All medical charts of keratoconic patients attending both centres over the period from 2009 to 2016 were reviewed. These patients were diagnosed by ophthalmologists depending on history, examination and Pentacam. Severity was determined using the k median index from the Pentacam map. Data analysis was carried out using SPSS Version 22. Results: The medical files of 936 keratoconic eyes of 505 keratoconic patients were reviewed. Their mean age at the time of diagnosis was 23.3 ranging from 8 to 62 years. Approximately 70.1% of them presented after the age of 20 years, and younger age groups were more likely to develop a severe disease stage than older ones (P = 0.001, r = − 0.108). There was a nearly equal distribution of patients between the two sexes (49.5% male, 50.5% female). On initial evaluation, the best-corrected visual acuity (BCVA) was recorded as ≥6/12 in most affected eyes (71.5%). Regarding severity, 62% presented in a mild form, while 9.9% were at a severe stage. About 88.2% presented with bilateralism. Conclusions: Most of the patients in their twenties presented with a mild bilateral form of the disease. This result is compatible with published international reports. It is recommended that the results of this study be considered when establishing a screening program in Palestine. Subsequently, patients will be identified at an appropriate time where action can be taken before disease progression take place.