Relationship of idiopathic preretinal macular fibrosis to posterior vitreous detachment

Of 100 consecutive cases of spontaneous posterior vitreous detachment, 20 patients had bilateral posterior vitreous detachments, and 50 patients experienced light flashes just before, or at the moment, that they noticed a floating opacity. Most patients had no loss of vision at the time. A prominent provoking factor rarely caused the detachment. In five cases there were hemorrhages at the disk where the posterior attachment of the vitreous body was torn from the disk margin. Six peripheral retinal holes were found in patients with posterior vitreous detachments and in four, the holes were fresh and three were associated with fresh blood in the peripheral vitreous body. There was no attachment between the posterior face of the receding vitreous body and the macular region. There were no macular pathologic findings in this study and there was no secondary pathology anywhere near the macula at the posterior pole. Spontaneous preretinal macular fibrosis did develop in two cases after posterior vitreous detachment, but only after more than two years and in the absence of any vitreoretinal adhesion.