[Involutional ophthalmic endotoxicosis as the cause of the involutional vitroretinal syndrome]

The author regards a characteristic complex of ocular changes in elderly subjects, including alterations in the posterior lenticular capsule, vitreous destruction, and retinal glial plaques presenting as coin-like, flap, and other light reflexes of the fundus oculi, as the involution vitreoretinal syndrome (IVS). Examinations of 201 subjects aged 51 to 98 at a nursing home for elderly subjects revealed this syndrome in 17 (34 eyes). Few patients with IVS among elderly subjects and examinations of 124 patients with this condition hospitalized to rule out a chronic inflammatory process gave grounds to consider that, besides old age, an additional injurious factor contributes to the development of IVS. He considers that the appearance of toxic elements in the humor (ophthalmoendotoxicosis) may be this factor, because the beginning of IVS is characterized by injury to ocular tissues which come in contact with the slit-like space filled with aqueous humor. IVS may involve such complications as nuclear cataract, dystrophic detachment of the retina, macular edema, retinal fibroplasia. According to current notions, immune mechanisms contribute to the development of these conditions. Analysis of morphologic findings and published data on the age-specific changes in the organs with hemato-organ barrier brought the author to a conclusion that in patients with IVS, opthalmoendotoxicosis, promoting the impairment of the hemato-ophthalmic barrier, leads to complications caused by an autoimmune conflict.