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III.G. Vitreous in Age-Related Macular Degeneration

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Vitreous

Abstract

Due to the increasing importance of age-related macular degeneration (AMD) in the modern western world an enormous number of scientific papers have been published concerning the epidemiology, pathogenesis, morphology, and therapy of this disease. All these articles mainly concentrated on changes of the posterior part of the retina, as AMD is a disease of the chorioretinal interface, specifically the retinal pigment epithelium/Bruch’s membrane/choriocapillaris complex. In the past, only a few studies examined the relationship of the posterior vitreous cortex and the retina and changes at the vitreo-macular interface in eyes suffering from AMD. Weber-Krause et al. conducted a study based on B-scan ultrasound and reported a higher incidence of incomplete posterior vitreous detachment (PVD) in eyes with AMD compared to age-matched controls [1]. Similarly, Ondes et al. found that complete PVD was more frequent in eyes without AMD compared to eyes with AMD [2]. Neither study specifically evaluated the vitreo-macular relationship in AMD, although it was implicit that anomalous PVD may play a role, as it does in other conditions [see chapter III.B. Anomalous PVD and vitreoschisis].

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Author information

Authors and Affiliations

  1. Department of Ophthalmology, Ludwig Boltzmann Institute for Retinology and Biomicroscopic Laser Surgery, Rudolf Foundation Clinic, Juchgasse 25, Vienna, 1030, Austria

    Ilse Krebs MD, Carl Glittenberg MD & Susanne Binder MD

Authors
  1. Ilse Krebs MD
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  2. Carl Glittenberg MD
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  3. Susanne Binder MD
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Corresponding author

Correspondence to Susanne Binder MD .

Editor information

Editors and Affiliations

  1. VMR Institute for Vitreous Macula Retina, Huntington Beach, California, USA

    J. Sebag

Electronic Supplementary Material

Video III.G-1

VMT with CNV (virtual C-mode and RPE-fit slab). This video shows how to visualize the correlation between VMT and a CNV located immediately beneath it using the RPE-fit slab capability of the Carl Zeissâ„¢ Cirrus HD-OCT. By creating a virtual C-mode visualization, whose contour can be adjusted to fit the contour of the RPE, it is possible to show the exact location of the CNV and its relationship to the forces of vitreo-macular traction and adhesion immediately above it (AVI 131278 kb)

Video III.G-2

VMT with no CNV (virtual C-mode and RPE-fit slab). This video shows the same method as described in Video III.G-1 used on a patient with VMT and no CNV for the sake of comparison. The same process of scrolling through the RPE-fit virtual C-mode scan reveals no CNV relating to the area of the VMT (AVI 131278 kb)

Video III.G-3

VMT with CNV (real-time interactive voxel rendering). This video shows a real-time screen-grab of the voxel rendering system in use. The system is based on a plug-in that was written for the 3D rendering and animation program Maxonâ„¢ Cinema 4Dâ„¢. This system has the capability of creating real-time visualizations of segmentational data sets. It differs fundamentally from conventional visualization systems in as much as it creates ray-traced shading directly on the data set interactively. This capability greatly increases the detail and quality of the visualization (AVI 131278 kb)

Video III.G-4

VMT with CNV (voxel rendering). This video shows the same case as in Videos III.G-1 and III.G-3 visualized using a prerendered voxel visualization as described in Video III.G-3. The white arrow shows the location of the CNV under the VMT and adhesion. As can be seen in the visualization, the direction of the folds in the VMT points at the location of the CNV indicating a correlation between tractional forces and the presence of CNV (AVI 131278 kb)

Video III.G-5

VMT with CNV (real-time interactive GPU rendering). This video shows the same case as in Videos III.G-1, III.G-3, and III.G-4 visualized using a GPU-based triangle-mesh segmentation visualization system designed using CUDA algorithms and rendered on an Nvidea GTX GeForce 590 graphics card. This video shows a screen-grab of the interactive real-time capabilities of the system. The black lines show the correlation between the tractional forces of the VMT and the location of the CNV (AVI 131278 kb)

Video III.G-6

VMT with CNV (GPU rendering). This video shows the same case as in Videos III.G-1, III.G-3, III.G-4, and III.G-5 using the same visualization system described in Video III.G-5. This video is a prerendered animation (non-real time) showing the correlation between the VMT and the location of the CNV (black lines) (AVI 131278 kb)

Video III.G-7

VMT with no CNV (GPU rendering). This video shows the same case as in Video III.G-2 using the visualization system described in Videos III.G-5 and III.G-6. In this case, there is VMT and MP but no underlying CNV. (AVI 131278 kb)

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Krebs, I., Glittenberg, C., Binder, S. (2014). III.G. Vitreous in Age-Related Macular Degeneration. In: Sebag, J. (eds) Vitreous. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1086-1_19

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