Posterior vitreous cortex characteristics of an eye with asteroid hyalosis

To describe both the clinical and the histological characteristics of the vitreoretinal interface of an eye with asteroid hyalosis (AH).

A 76-year-old woman presented with a left eye with AH and an epiretinal membrane (ERM). Preoperative slit-lamp biomicroscopy revealed anatomical posterior vitreous detachment with a Weiss ring. Preoperative best-corrected visual acuity (BCVA) was 20/50. The patient underwent triamcinolone acetonide-assisted vitrectomy, along with peeling of the internal limiting membrane (ILM). The ERM and ILM were removed together with surgical ILM forceps. The excised ILM was analyzed with transmission electron microscopy (TEM). We also compared the histological characteristics of this tissue with those of tissue from a non-AH eye with idiopathic ERM.

A massive collagenous matrix with few cellular components, suggesting residual posterior vitreous but not ERM, was observed on the excised ILM of the AH eye. BCVA improved to 20/25 6 months after surgery. TEM of a non-AH eye with idiopathic ERM revealed a cellular rich component and extracellular matrix on the ILM.

We found evidence demonstrating a split in the posterior vitreous cortex, representing, to our knowledge, the first case report of this phenomenon in an eye with AH.