Asteroid Hyalosis: An Update on Prevalence, Risk Factors, Emerging Clinical Impact and Management Strategies

Asteroid hyalosis (AH) is a benign clinical entity characterized by the presence of multiple refractile spherical calcium and phospholipids within the vitreous body. First described by Benson in 1894, this entity has been well documented in the clinical literature and is named due to the resemblance of asteroid bodies on clinical examination to a starry night sky. Today, a growing body of epidemiologic data estimates the global prevalence of asteroid hyalosis to be around 1%, and there is a strong established association between AH and older age. While pathophysiology remains unclear, a variety of systemic and ocular risk factors for AH have recently been suggested in the literature and may provide insight into possible mechanisms for asteroid body (AB) development. As vision is rarely affected, clinical management is focused on differentiation of asteroid hyalosis from mimicking conditions, evaluation of the underlying retina for other pathology and consideration of vitrectomy in rare cases with visual impairment. Taking into account the recent technologic advances in large-scale medical databases, improving imaging modalities, and the popularity of telemedicine, this review summarizes the growing body of literature of AH epidemiology and pathophysiology and provides updates on the clinical diagnosis and management of AH.