| Popis: |
At present, it is believed that the detachment of the vitreous body occurs due to the contraction and liquefaction of the vitreous body, while the exit of the liquid part of the vitreum into the retrovitreal space passes passively through the formed prepapillary opening, after which the vitreous body collapses, however, more precise mechanisms have not been described. Purpose. Substantiate a hypothesis of influence of intravitreal hydrodynamics in inducing detachment of the posterior hyaloid membrane based on the analysis of OCT data. Material and methods. An OCT study was performed in 30 patients with initial detachment of the posterior hyaloid membrane (PHM) with macular adhesion, macular traction, and macular hole. The features of the location of the PHM in the region of the macula, foveola and the place of attachment of the PHM to the optic nerve were studied. Results and discussion. As a result of the analysis of OCT images, it was found that with macular holes, macular adhesion and macular traction, a closed space is formed between the posterior hyaloid membrane and the retina (subbursal space) in the form of a dome, which indirectly indicates an increase in pressure within this space. In 28 patients, the zone of dissection or thinning of the PHM was found parapapillary, through which the intraocular fluid is likely to be injected into the subbursal space. Conclusions: This study suggests the leading role of intravitreal hydrodynamics and the formation of an area of increased pressure in the subbursal space in the induction of the detachment of the PHM, the pathogenesis of vitreomacular adhesion, vitreomacular traction and macular hole. The topic requires more detailed study. Key words: posterior hyaloid membrane, OCT, vitreous body, macular hole. |
