Symptomatic Vitreous Opacities: Exploring the Mismatch between Clinical Observation of Vitreous Alterations and Self-Reported Symptoms

Journal of Clinical Medicine, vol. 13, pp. 6052

Abstract

Objectives: To assess the mismatch between the clinical observation of vitreous alterations and self-reported symptoms in young patients complaining of symptomatic vitreous opacities (SVO). Methods: The ophthalmic medical records of young patients presenting primarily with SVO were retrospectively evaluated. Symptoms severity was assessed using a questionnaire. The status of the vitreous body was examined with indirect ophthalmoscopy at the slit-lamp and classified according to an ad hoc severity scale. Results: Sixty eyes of thirty otherwise healthy patients (median age: 32.5 (IQR: 29.0–37.0) years old) complaining of SVO (median duration: 38 months; interquartile range: 18–84 months) were enrolled. SVO was rated as severe by 50% of participants, affecting all the activities explored in the questionnaire. Twenty-three patients (76.6%) reported SVO-related depression and/or anxiety, for which eleven patients (36.6%) were or had been using medication. Fifty-eight eyes (96.6%) showed no evidence of (or minimal) vitreous opacity, while two eyes (3.3%) were found to have significant vitreous opacity. No significant inter-gender differences (p > 0.05) and no significant differences (p > 0.05) were found between the severity of vitreous opacity and patients’ reported symptoms nor with their psychological status and medication use. Conclusions: Severe discomfort related to the perception of vitreous floaters exists in young patients whose vitreous gel examination is unremarkable or shows only minor alterations. We believe this discrepancy can be explained by optical anisotropy; significant forward-scattering of light, which results in floater symptoms; and reduced back reflection, which limits the clinical observation.

Authors 14

1. Giulio Bamonte

   Universitair Ziekenhuis Brussel · Haga Hospital

   Affiliation as printed

   Department of Ophthalmology, Brussels University Hospital, Av. du Laerbeek 101, 1090 Jette, Belgium

   Department of Ophthalmology, HagaZiekenhuis, Els Borst-Eilersplein 275, 2545 AA The Hague, The Netherlands

2. Clemente Maria Iodice corresponding

   Sapienza University of Rome

   Affiliation as printed

   Faculty of Medicine and Dentistry, University of Rome “La Sapienza”, 00185 Rome, Italy

   Faculty of Medicine and Dentistry, University of Rome "La Sapienza", 00185 Rome, Italy

3. Rodolfo Mastropasqua

   University of Chieti-Pescara

   Affiliation as printed

   Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D’Annunzio Chieti-Pescara, 66100 Chieti, Italy

   Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, 66100 Chieti, Italy

4. Elon H. C. van Dijk Aachen Department of Ophthalmology, Leiden University Medical Center

   Leiden University Medical Center

   Affiliation as printed

   Department of Ophthalmology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands

5. Andrea Appeltans

   Universitair Ziekenhuis Brussel

   Affiliation as printed

   Department of Ophthalmology, Brussels University Hospital, Av. du Laerbeek 101, 1090 Jette, Belgium

6. Maria Vittoria Cicinelli

   Vita-Salute San Raffaele University · IRCCS Ospedale San Raffaele · Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele

   Affiliation as printed

   Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132 Milan, Italy

   School of Medicine, Vita-Salute San Raffaele University, Via Olgettina, 58, 20132 Milan, Italy

7. Matteo Menean

   Vita-Salute San Raffaele University · IRCCS Ospedale San Raffaele · Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele

   Affiliation as printed

   Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132 Milan, Italy

   School of Medicine, Vita-Salute San Raffaele University, Via Olgettina, 58, 20132 Milan, Italy

8. Marcel Ten Tusscher

   Universitair Ziekenhuis Brussel

   Affiliation as printed

   Department of Ophthalmology, Brussels University Hospital, Av. du Laerbeek 101, 1090 Jette, Belgium

9. Stuart William Harmer

   University of Chichester

   Affiliation as printed

   Applied Electromagnetics Research Group, Department of Engineering, Computing and Design, College Lane, University of Chichester, West Sussex, Chichester PO19 6PE, UK

10. Paola Marolo

    University of Turin

    Affiliation as printed

    Department of Surgical Sciences, University of Turin, 10124 Tulin, Italy

11. Enrico Borrelli

    University of Turin

    Affiliation as printed

    Department of Surgical Sciences, University of Turin, 10124 Tulin, Italy

12. Michele Reibaldi

    University of Turin

    Affiliation as printed

    Department of Surgical Sciences, University of Turin, 10124 Tulin, Italy

13. Georgios D. Panos corresponding

    University of Nottingham · Aristotle University of Thessaloniki

    Affiliation as printed

    Department of Ophthalmology, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece

    Division of Ophthalmology and Visual Sciences, School of Medicine, University of Nottingham, Nottingham NG72UH, UK

14. Lorenzo Motta

    University of Padua

    Affiliation as printed

    Department of Ophthalmology, School of Medicine, University of Padova, 35121 Padova, Italy