Vitreous floaters (disturbed translucency of the vitreous body)

The vitreous body (Lat. corpus vitreum) is a jelly-like, translucent substance filling up the posterior part of the eyeball. The vitreous body helps to maintain the eyeball’s spherical shape and mediates in the nutrition of the eye internal tissues. It presses the loosely lying retina against the eyeball walls and prevents retinal detachment. The vitreous body is made up of a net of loosely arranged collagen fibres and hyaluronic acid, with water locked in between them and constituting ca. 90% of the vitreous body composition.

Disturbances of the vitreous body translucency are one of the most frequent complaints reported by patients in ophthalmology offices. Most frequently, patients report the presence of the so called vitreous floaters. Vitreous floaters are seen as numerous and moving grey or black spots (the so called flies) or threadlike creatures resembling worms. Additionally, in advanced cases of vitreous opacity, there may be flashes of light, accompanying sudden changes of head position or shocks.

The most frequent cause of vitreous floaters are degenerative processes occurring within the vitreous body, which lead the changes in the structure of the vitreous collagen fibres (greater number of links between the collagen fibres, creation of conglomerates, shortening and twisting of the fibres). Degenerative processes of the vitreous body are related to the harmful activity of free radicals and attachment of glucose particles to the collagen fibres (the so called collagen fibre glycation).

There are several stages of the vitreous body degenerative processes. The first and often asymptomatic stage is the so called fibrillar degeneration, consisting in the generation of numerous additional links between the collagen fibres of the vitreous body. With time, there may appear symptoms that are observable by the patient, such as the above mentioned flying flies or threadlike creatures. Research shows that fibrillar degeneration occurs in ca. 34% of people aged 10 to 40.

Numerous bonds between the collagen fibres cause the water filling up the space in between them to be pushed out of it, and as a result another stage of vitreous degeneration occurs, called the liquefaction of the vitreous body. It consists in the creation of water-filled chambers within the vitreous body. Liquefaction of the vitreous body develops in ca. 25% of people aged 40-45 and 60% of people over 80.

Further degenerative changes of the vitreous collagen fibres involve the twisting and shortening of the collagen fibres and lead to the shrinkage of the vitreous body. The vitreous body then separates from the posterior pole of the eyeball, to which it is attached most weakly. The phenomenon is known as posterior vitreal detachment (PVD). Posterior vitreal detachment can be observed in ca. 6% of people over 50, and ca. 65% of people over 65. Posterior vitreal detachment may lead to serious complications in the form of haemorrhages to the vitreous body, retinal detachment or retinal tear.

Recent scientific research has shown that degenerative changes of the vitreous body are inhibited by antioxidant substances, which neutralize free radicals in aqueous environment (e.g. ascorbic acid) as well as by the substances which inhibit collagen fibre glycation (L-lysine, procyanidin).

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