Classification and treatment of vitreous opacities

  Vitreous humor is a colorless and transparent colloid with water as the main component, about 99%, and the main molecular components are slender collagen and hydrophilic hyaluronic acid. Under normal conditions, the vitreous body has few cells, no blood vessels, slow ageing, and a high degree of transparency.  There are several types of vitreous opacities: the first type is congenital opacities, which are abnormal residues from embryonic development.  The second type is endogenous clouding, which is caused by the degeneration of the vitreous itself. The first is a posterior vitreous detachment with a posterior vitreous fissure, which is often seen as a ring-shaped black shadow in front of the patient’s eyes, and is more common in highly myopic patients; the second is stellate vitreoretinopathy, which is more common in older men; and the third is called glow-like vitreous liquefaction, which may be related to atherosclerosis and hypercholesterolemia. All three types of degeneration have little effect on vision.  The third type is exogenous opacities, which often affect vision and can lead to perivitreous tissue lesions. The common ones are: (1) vitreous hemorrhage; (2) intravitreal inflammatory exudate; (3) intravitreal pigmentation; (4) intraocular tumors; and (5) intravitreal parasites.  The main clinical symptom of vitreous turbidity is a black shadow in front of the eyes, mostly accompanied by eye movements. Mild vitreous turbidity basically does not affect vision but the quality of vision is reduced, while severe vitreous turbidity can lead to vision loss or even blindness.  After years of clinical research and practical accumulation, there are many treatment methods and means for this disease in Western medicine. In general, the first is anti-inflammatory or hemostatic treatment for the cause, followed by the application of iodine preparations, hyaluronidase, urokinase or calcium agents to promote absorption; the use of physical therapy such as ultrashort wave, or ultrasound and sodium iodide iontophoresis, etc. Severe vitreous opacities can be treated by surgical methods such as vitrectomy if conservative treatment is ineffective. In addition, current research shows that traditional Chinese medicine in the treatment of vitreous turbidity also has some effect.