A Retrospective Chart Review: The Presence of Anterior Hyaloid Separation Sign in Posterior Vitreous Detachment

Background and objective The presence of Weiss ring is classically used to aid in the diagnosis of posterior vitreous detachment (PVD) but may at times be challenging to visualize under slit-lamp biomicroscopy. The anterior hyaloid separation sign (AHSS) is a previously undescribed sign that is seen among patients with PVD as a "veil of vitreous" in the anterior vitreous cavity. AHSS is easier to visualize than Weiss ring and may prove useful in settings where Weiss ring detection is not feasible. Methods This study analyzed the connection between the presence of AHSS among the PVD population. A retrospective chart review of patients with established PVD (n=214) enrolled at Mason Eye Clinic (Columbia, Missouri, United States) between February 1, 2023, and October 1, 2023, was performed. All patients with a confirmed diagnosis of PVD were stratified as exhibiting AHSS or not exhibiting AHSS. Data including patient demographics, lens status, and ocular comorbidities were collected.  Results The mean age was 70.3 years, 72% were females, and 93.9% were Caucasians. Ocular comorbidities include epiretinal membrane (17.8%), retinal tear (9.8%), proliferative diabetic retinopathy (5.1%), retinal vein occlusion (4.7%), uveitis (4.7%), rhegmatogenous retinal detachment (4.2%), and sickle cell disease (1%). Around 56.2% of cases were newly diagnosed PVD, while 43.8% were long-standing PVD. Among all PVD cases (n=214), 89.7% (n=192) presented with AHSS, whereas 10.3% (n=22) did not present with AHSS. The chi-squared goodness-of-fit test compared this study's AHSS prevalence in PVD with the general PVD population. Analysis revealed a significant prevalence between the presence and absence of AHSS in PVD patients at 84% (p=0.02).  Conclusion The presence of AHSS has a high prevalence among patients with PVD and holds value in aiding the diagnosis and confirmation of PVD.