PVD, which is short for Posterior Vitreous Detachment, is a syndrome of eye that vitreous gel separate from the retina, meaning detachment. Vitreous gel is located behind the lens of eyes which is attached to retina at birth. However, with time goes by, the changes, either shrinking or liquefaction happening at the interface, will lead to the sudden peeling away of vitreous from retina. A study shows that age and refractive error are two important causes of PVD, which means elder and myopia people are more likely to be attacked by this disease.
APVD, which means Anomalous PVD, is a consequence of more excessive gel liquefaction than the degree of vitreoretinal dehiscense which is judged by the strongest vitreoretinal dehiscense located at the base in clinical way. Along the periphery of vitreous gel, detachments and retinal tears are more likely to be induced by APVD. And within the vitreous gel, vitreomacular traction syndrome with the symptom of vitreoschisis within the macular holes, or diabetic macular edema is more likely to be caused by APVD. While at the edge of retina and optic disk, vitreopapillary traction, with the consequence of nevovasculation, is more likely to be caused by APVD.
But the question on how to treat or prevent APVD in an effective way is emphasized by lots of eye doctors. Finally, the researchers find gel liquefaction and vitreoretinal dehiscense are two key components of PVD. So experts decide to use the method of pharmacologic vitreolysis to break down vitreous macro-molecules and weaken vitreoretinal adhesion to further mitigate APVD. This is a safe way to help to prevent the disease from becoming more serious, especially during the initial period of the disease. This is called unifying theory.
We know APVD is due to the continuous attachment of vitreous gel since the initial shrinking, so chemicals, microfibrin, or fabrin are greatly used to promote the releasing of vitreous from the traction exerting to the retina. It is a valuable discovery for the PVD patients, especially the young. As for the old patients, they find it unnecessary to do the surgery as their vitreous has changed so much. The treatment on APVD still has a long way to go. Discussion and researches should be the main direction in the future.
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