Vitreolysis – TREATMENT of myodaeopsia

Our task is to preserve your vision!

Quite often our patients complain of floating opacities in front of their eyes, in the shape of “flies”, points, lines and foreign inclusions that obscure vision and interfere with daily life. Having appeared once, they haunt us all the time – at work and at home, giving us unpleasant sensations. Vitreous degeneration (myodaeopsia) occurs in 70-80% of patients and is currently one of the most common eye problems.

You should know! It is important to identify the cause of floaters, first of all, in order to ensure that the condition of the vitreous body is not threatening to sight.

You should remember! The cause of floaters can be either harmless degeneration of the vitreous body, or more serious pathology, which can lead to loss of sight!

To determine the cause of floaters, a careful eye examination is required, including examination of the vitreous and retina with a wide pupil. Vitreous degeneration (myodaeopsia) is the most common cause of floaters. High incidence of myodaeopsia in individuals over the age of 40 is typical, as it occurs in 70-80% of them. However, such a problem is not only found in adults. The incidence of floaters has been increasing, including in young people and adolescents.

You should know! Floaters can arise at any age! It is important to identify their cause and take appropriate measures!

n our clinic, we pay great attention to diseases of the vitreous body; laser treatment – vitreolysis – is carried out by experienced specialists according to international standards. We only use modern equipment produced by world leading manufacturers!

WHAT COULD CAUSE FLOATERS?

Many factors can provoke myodaeopsia. Most often they are associated with age-related changes that begin to manifest at 40-50 years of age. Among other reasons, there are vascular disorders, metabolic and endocrine abnormalities, cervical osteochondrosis, injuries of the head, nose and eyes, high toxic and radiation exposure, past infectious and parasitic diseases.

Myodaeopsia may take the form of gold or silver rain. The disease occurs due to crystal inclusions: cholesterol, calcium, phosphorus, magnesium salts, which is found in patients with metabolic disorders. Examination using a slit lamp reveals clearly visible shiny particles that move following the movement of the eyeballs. This disorder usually occurs in older people, but in patients with myopia it may occur earlier. The pathology is associated with posterior vitreous detachment and does not pose a threat. Conventional myodaeopsia is considered relatively harmless; it does not result in a significant deterioration of vision or threatening conditions.

Sometimes there are physiological phenomena that can be mistaken for pathology. Looking at the sky on a clear day, you can see, close to the area of focus, bright spots moving one after the other, with clearly visible gaps. Such a phenomenon is explained by the movement of erythrocytes in the capillaries in the central part of the retina. The gaps are leucocytes.

Only careful examination can determine the difference between physiological and pathological floaters. The examination is carried out by means of special lenses, such as Goldman’s. It allows examining all parts of the vitreous and fundus.

Here are common causes of floaters:

• vitreous degeneration;
• myopia (nearsightedness);
• early retinal detachment;
• diabetes
• stress
• metabolic disorders;
• bleeding in the retina and the vitreous;
• posterior vitreous detachment with a Weiss ring at the optical center;
• vitreous opacities after uveitis and other inflammatory diseases of the eye;
• frequent hemophthalmia;
• asteroid bodies;
• entopic phenomena;
• ocular migraine;
• hallucinations
• poisoning and intoxication.

You should know! Many factors, both external and internal, may influence the condition of the vitreous body, which can lead to dangerous complications such as retinal detachment and its breaks! Do not delay a visit to the doctor! Timely treatment of myodaeopsia is an important step towards preserving good vision in the future!

WHAT is myodaeopsia?

Myodaeopsia is an abnormality of the original structure of the vitreous as a result of changes in individual fibers that lose their transparency and thicken. It is explained by age-related physical degeneration, accompanied by breaking and agglutinating fragments of the vitreous, forming conglomerates. They become visible in the form of threads, “flies” and other floaters. They are especially noticeable against the backdrop of a bright light surface, such as clear sky, white snow, bright and illuminated interior objects. The spots have a shape of dark bodies that move smoothly when the eyes move

Important! To self-assess the condition of the vitreous body for the presence of floaters, it is enough to look at a bright surface, a clear sky. If you see inclusions, then consult your ophthalmologist!

Conservative treatment of myodaeopsia

If we talk about the treatment of floaters not related to serious pathology and not resulting in vision deterioration, at the moment, there are very few drugs with proven efficacy that are able to remove floaters or prevent the emergence of new ones. The most popular drugs are Emoxipine, Taufon, 3% potassium iodide drops, as well as Wobenzym (ingestion drug). Most of the anti-myodaeopsia drugs are able to prevent progression of the disease. It is worth noting an increased popularity of folk cures for floaters, such as fennel infusion, chickweed compresses, peony infusion, geranium and many others. However, self-treatment by non-medical methods can be dangerous! The same goes for dietary supplements, increasingly popular in the treatment of various diseases. Of course, there are excellent and high quality dietary supplements for the treatment of myodaeopsia, but the positive result can be achieved only providing complex treatment, which can be prescribed only by your doctor. Unfortunately, many manufacturers of dietary supplements speculate on the problem of floaters and insist on the efficacy of their products. Take care of your health!

You should know! Anti-myodaeopsia drops and pills do not completely eliminate floaters, but it is possible to slow down their appearance with the help of well-chosen drugs.

Vitreolysis. Laser treatment of myodaeopsia

To date, laser treatment of myodaeopsia is most effective: floaters that can be observed by the doctor get divided into small particles and do not impair vision.

The first tests of YAG-laser for vitreolysis were conducted by Professor Frank Fankhouser, a pioneer in laser ophthalmology. Author of several studies on laser treatment of cataract, an authoritative representative of the medical community, he began to study methods of laser treatment of vitreous opacities.

The first findings in the treatment of myodaeopsia by vitreolysis were published in 1985. Abroad, this technique is used by well-known ophthalmologists: Scott Geller and John Karickhoff in the US, Brendan Moriarty in the UK, and so on. Doctors performing this procedure are perfectly familiar with its high efficiency. The scientific literature contains a lot of articles that confirm the safety of laser vitreolysis.

What is laser vitreolysis?

Vitreolysis is performed using a neodymium YAG-laser. Successful treatment requires accurate focusing – not less than 6 microns. Energy use is 4-6 mJ. The number of flashes varies from 200 to 600. The therapy requires on average 1-4 treatments.

The method of vitreolysis has special features. Unlike in procedures using YAG-laser (iridotomy, posterior capsule discission), vitreolysis is more complex since it is a manipulation with moving objects.

This laser treatment is carried out if the opacity of the vitreous body deteriorates vision or if there is the risk of vitreoretinal traction.

How is vitreolysis performed?

Laser treatment of myodaeopsia is performed on an outpatient basis, using local eye drop anesthesia, which does not impact the heart, vessels and other internal organs. First, special drops extending the pupil are instilled. After anesthesia a special lens (three-mirror Goldmann's lens) is placed upon the eye, which allows focusing the laser beam on the desired area of the vitreous. Laser vitreolysis is performed without blood loss and discission; local anesthesia eliminates pain. The patient can feel the touch of the lens, as well as hear the clicking noise of the laser system. After the procedure it is recommended to stay under the supervision of a specialist for some time. Once the doctor makes sure that everything is all right, the patient can go home.

What complications could follow vitreolysis?

Vitreolysis is a very delicate procedure, but there may be such complications as:

1. increased intraocular pressure;
2. choroidal microhemorrhages;
3. retinal detachment;
4. cataract

You should know! Most of the complications and postoperative conditions are predictable. An experienced ophthalmologist is able to assess potential risks of the procedure and compare them to the anticipated effect!

Contraindications to vitreolysis

1. opacity of optical media and obstacles to the passage of the laser beam (hyphema or suspension in the moisture of the anterior chamber, cataract, corneal opacity and edema);
2. luxation of the lens into the vitreous;
3. expressed neovascularization;
4. high risk of hemorrhage according to the blood value;
5. retinal detachment;
6. choroid detachment.

Some of these contraindications may be relative.

You should know! Modern approach to the treatment of pathological changes in the vitreous, employed in our clinic, can significantly improve the quality of life and eliminate the risk of possible complications and loss of vision in the future!

To make an appointment at Dr. Kurenkov’s Clinic or get information on the cost of examination and treatment, please call +7 (495) 781-9333.

The cost of vitreolysis in Dr. Kurenkov’s Clinic starts from 3,000 rubles.