Infrared Video Imaging for the Identification and Quantification of Macula-Involving Symptomatic Vitreous Opacities

Purpose: To evaluate whether infrared video imaging can supplement traditional examination and imaging methods to identify and quantify symptomatic vitreous opacities. Methods: A prospective nonrandomized nonmasked series was performed that included eyes of consecutive patients with a primary complaint of symptomatic vitreous opacities. A macular vitreous opacity score (0-4) was developed to grade the size of the opacities in relation to the macula after refixation of up, down, left, and right saccades. Grade 0 indicated an absence of opacities. Grades 1 to 4 represented how many quadrants of the macula were obscured by opacities for more than 50% of the total video capture time (grade 1 = 1%-25%; grade 2 = 26%-50%; grade 3 = 51%-75%; grade 4 = 76%-100%). Grade 2 opacities were divided into subcategories 2A and 2B depending on whether they were central enough to obscure the fovea for more than 50% of the time. Results: The study comprised 52 eyes of 40 patients. Thirty-two eyes (62%) with symptomatic vitreous opacities were grade 1, 6 (11%) were grade 2A, 6 (11%) were grade 2B, 5 (10%) were grade 3, and 3 (6%) were grade 4. Conclusions: Infrared video imaging is a useful supplement to traditional examination and imaging methods for the identification and quantification of symptomatic vitreous opacities. The macular vitreous opacity score can help standardize vitreous opacity documentation in the clinical setting for future case selection.