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Research Letter |

Development of a Premacular Vitreous Pocket

Tadashi Yokoi, MD, PhD1; Naoki Toriyama, MD1; Takahiro Yamane, MD, PhD1; Yuri Nakayama, MD1; Sachiko Nishina, MD, PhD1; Noriyuki Azuma, MD, PhD1
[+] Author Affiliations
1Department of Ophthalmology and Cell Biology, National Center for Child Health and Development, Tokyo, Japan
JAMA Ophthalmol. 2013;131(8):1095-1096. doi:10.1001/jamaophthalmol.2013.240.
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The premacular vitreous pocket (PVP), or vitreoschisis cavity, is a liquefied vitreous cavity in front of the posterior retina that is characteristic of various macular diseases, including macular holes and diabetic maculopathy.1 The reason for the development of PVPs is unknown because of the difficulty observing the formed vitreous in vivo. India ink and the fluorescein staining technique have delineated the structure of the PVP in the vitreous cavity in human eyes at autopsy2; however, the technique is limited because of the presence of artifacts during fixation of the fragile and mobile vitreous and postmortem changes. Optical coherence tomography has facilitated observation of the vitreous structures in vivo. Herein, we describe the development and fine details of PVPs in real time.

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Figure 1.
Age-Dependent Changes in Premacular Vitreous Pockets

A, No premacular vitreous pocket is seen in the eye of a 2-year-old boy. B, A premacular crack in the formed vitreous (arrowheads) is seen in the eye of a 3-year-old girl, and the Cloquet canal is connected to the crack. Premacular vitreous pockets are seen in the eyes of an 8-year-old boy (C), a 13-year-old boy (D), a 30-year-old man (E), and a 54-year-old woman (F), and they are all connected to the Cloquet canal. F, A partial posterior vitreous detachment is seen in the eye of a 54-year-old woman.

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Figure 2.
Multifocal Premacular Vitreous Pockets (PVPs) and Temporal Remnants of Regressed Hyaloid Vessels With a PVP

A-C, Sequential radial sections of the temporal premacular vitreous centered on the optic disc in the eye of a 6-year-old boy. Primitive PVPs are seen superotemporally (A) and inferotemporally (C) but no PVPs are seen temporally (B), indicating that these PVPs are multifocal in origin. D, A regressed hyaloid vessel within both the Cloquet canal and a PVP (arrows) is seen by swept-source optical coherence tomography in the eye of a 5-year-old boy.

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