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Grades of Vitreous Clarity

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The Uveitis Atlas
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Abstract

The vitreous humor is a transparent gel-like structure occupying the space between the retina, ciliary body, and the lens. The vitreous body forms very early during pregnancy and undergoes rapid transformation in three phases. The most important function of the vitreous from the sensory standpoint is to allow transmission of visible light to the retina. Vitreous clarity and light transmission capabilities also are functions of the index of refraction of the vitreous body, the specific structural composition and high level of organization of the collagen fibers. Vitreous haze from uveitis is produced by penetration of inflammatory cells and protein exudation into the vitreous from adjacent structures and is caused by inflammation itself. The clearing of the vitreous haze is dependent on factors external to the vitreous. The amount of the vitreous haze is judged currently by photographic scales. The older “NEI” scale has six ordinal grades of vitreous opacification ranging from (0) to (4 +). A newer logarithmic scale – “Miami” scale offers more levels of vitreous haze discrimination at the lower end of opacification; it has nine levels. Vitreous haze is accepted as surrogate marker for the disease activity in intermediate, posterior and panuveitis. Both scales are suitable for use for clinical grading, research trials, while the Miami scale is suitable also for reading center grading.

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  • Boettner EA, Wolter JR. Transmission of the ocular media. Invest Ophthalmol Vis Sci. 1962;1:776–83.

    Google Scholar 

  • Davis J, Madow B, Cornett JI, et al. Scale for photographic grading vitreous haze. Am J Ophthalmol. 2010;150(5):637–41.

    Article  PubMed  PubMed Central  Google Scholar 

  • Gao Q, Chen X, Ge J, Liu Y, Jiang Z, Lin Z, Liu Y. Refractive shifts in four selected artificial vitreous substitutes based on Gullstrand-Emsley and Liou-Brennan schematic eyes. Invest Ophthalmol Vis Sci. 2009;50(7):3529–34.

    Article  PubMed  Google Scholar 

  • Ghosn CR, Li Y, Orilla WC, Lin T, Wheeler L, Burke JA, Robinson MR, Whitcup SM. Treatment of experimental anterior and intermediate uveitis by a dexamethasone intravitreal implant. Invest Ophthalmol Vis Sci. 2011;52(6):2917–23.

    Article  CAS  PubMed  Google Scholar 

  • Hornbeak DM, Payal A, Pistilli M, Biswas J, Ganesh SK, Gupta V, Rathinam SR, Davis JL, Kempen JH. Interobserver agreement in clinical grading of vitreous haze using alternative grading scales. Ophthalmology. 2014;121(8):1643–8.

    Article  PubMed  PubMed Central  Google Scholar 

  • Hultsch E. Peripheral uveitis in the owl monkey: experimental model. Mod Probl Ophthalmol. 1977;18:247–51.

    CAS  PubMed  Google Scholar 

  • Jabs DA, Nussenblatt RB, Rosenbaum JT. Standardization of uveitis nomenclature for reporting clinical data: results of the First International Workshop. Am J Ophthalmol. 2005;140(3):509–16.

    Article  PubMed  Google Scholar 

  • Kempen JH, Ganesh SK, Sangwan VS, Rathinam SR. Interobserver agreement in grading activity and site of inflammation in eyes of patients with uveitis. Am J Ophthalmol. 2008;146(6):813–8.

    Article  PubMed  Google Scholar 

  • Kempen JH, Altaweel MM, Holbrook JT, Jabs DA, Sugar EA. Multicenter uveitis steroid treatment trial research group, the multicenter uveitis steroid treatment trial: rationale, design, and baseline characteristics. Am J Ophthalmol. 2010;149(4):550–61.

    Article  CAS  PubMed  Google Scholar 

  • Kimura SJ, Thygeson P, Hogan MJ. Signs and symptoms of uveitis: II. Classification of the posterior manifestations of uveitis. Am J Ophthalmol. 1959;47(5, Pt 2):171–6.

    Google Scholar 

  • Lowder C, Belfort Jr R, Lightman S, Foster CS, Robinson MR, Schiffman RM, Li XY, Cui H, Whitcup SM. Dexamethasone intravitreal implant for noninfectious intermediate or posterior uveitis. Arch Ophthalmol. 2011;129(5):545–53.

    Article  PubMed  Google Scholar 

  • Madow B, Galor A, Feuer WJ, Altaweel MM, Davis JL. Validation of a photographic vitreous haze grading technique for clinical trials in uveitis. Am J Ophthalmol. 2011;152(2):170–6.

    Article  PubMed  PubMed Central  Google Scholar 

  • Nussenblatt RB, Palestine AG, Chan CC, Roberge F. Standardization of vitreal inflammatory activity in intermediate and posterior uveitis. Ophthalmology. 1985;92(4):467–71.

    Article  CAS  PubMed  Google Scholar 

  • Odell NV, Leske DA, Hatt SR, Adams WE, Holmes JM. The effect of Bangerter filters on optotype acuity, vernier acuity, and contrast sensitivity. J AAPOS. 2008;12(6):555–9.

    Article  PubMed  PubMed Central  Google Scholar 

  • Ogston AG, Sherman TF. Effects of the hyaluronic acid upon diffusion of solutes and flow of solvents. J Physiol (Lond). 1961;156:67–74.

    Article  CAS  Google Scholar 

  • Pelegrín L, de la Maza MS, Molins B, Ríos J, Adán A. Long-term evaluation of dexamethasone intravitreal implant in vitrectomized and non-vitrectomized eyes with macular edema secondary to non-infectious uveitis. Eye (Lond). 2015;29(7):943–50.

    Article  PubMed Central  Google Scholar 

  • Secchi Memoria del PA. Relazione delle esperienze fatte a bordo della pontificia pirocorvetta l’Immacolata concezione per determinare la trasparenza del mare. Il Nuovo Cimento. 1864;20(1):205–38

    Google Scholar 

  • Swann DA, Constable IJ. Vitreous structure II. Role of hyaluronate. Invest Ophthalmol. 1972;11(3):164–8.

    CAS  PubMed  Google Scholar 

  • Theodossiadis G, Chatzoulis D, Karantinos D, Maguritsas N. Intraocular complications following Custodis-Lincoff operation. Arch Ophtalmol Rev Gen Ophtalmol. 1975;35(8-9):627–38.

    CAS  PubMed  Google Scholar 

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Correspondence to Brian Madow .

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Madow, B., Kempen, J.H. (2016). Grades of Vitreous Clarity. In: Gupta, V., Nguyen, Q., LeHoang, P., Herbort Jr., C. (eds) The Uveitis Atlas. Springer, New Delhi. https://doi.org/10.1007/978-81-322-2506-5_3-1

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  • DOI: https://doi.org/10.1007/978-81-322-2506-5_3-1

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