Vision degrading myodesopsia assessed with Optos ultra-widefield scanning laser ophthalmoscope

Vision degrading myodesopsia assessed with Optos ultra-widefield scanning laser ophthalmoscope | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Vision degrading myodesopsia assessed with Optos ultra-widefield scanning laser ophthalmoscope Tiezhu Lin, Cheng Shi, Bing Wu, Emmanuel Eric Pazo, Lijun Shen This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-3281891/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 20 Oct, 2023 Read the published version in BMC Ophthalmology → Version 1 posted 7 You are reading this latest preprint version Abstract Background To investigate the diagnostic sensitivity of Optos imaging for vision degrading myodesopsia (VDM). Methods A total of 420 eyes from 345 patients with VDM were collected in this cross-sectional study. All eyes were classified as having posterior vitreous detachment (PVD) or not having PVD. The sensitivity of Optos imaging for the visibility of vitreous floaters was evaluated. The associated factors with the visibility of vitreous floaters on Optos images were analyzed in univariate and multivariate logistic regression analyses. Results The mean age of all patients was 56.19 ± 13.89 years old, and 66.67% of patients were female. The vitreous floaters were visible on the ultrasound B scan in all eyes, but only in 47.62% of Optos images (55.29% in eyes with PVD and 15% in eyes without PVD). In the multiple binary logistic regression analysis, age (OR = 1.094, 95%CI = 1.063–1.125, P < 0.001), spherical equivalent (OR = 0.869, 95%CI = 0.791–0.955, P = 0.004) and the distance of the floaters from the retina (OR = 1.191, 95%CI = 1.059–1.339, P = 0.003) were significantly correlated with the visibility of vitreous floaters on Optos images. On Optos images, 25.71% of VDM eyes presented additional retinal abnormalities. Conclusions Optos imaging has a low sensitivity for vitreous floaters, particularly in eyes without PVD. On Optos imaging, floaters were more visible in older patients, eyes with greater myopia, and floaters that were further from the retina. Floaters Optos vision degrading myodesopsia scanning laser ophthalmoscope Figures Figure 1 Figure 2 Introduction VDM affects an increasing number of adults due to the global prevalence of myopia and the aging of the population [ 1 ]. As the eyes move, VDM may manifest as spots, cobwebs, shadows, and other diverse forms [ 2 , 3 ]. While floaters are typically only a minor annoyance, some eyes develop numerous symptomatic vitreous opacities that significantly impede reading, driving, and other daily visual activities. VDM can be diagnosed with a dilated fundus exam and/or an ultrasound B scan. Although the ultrasound B scan is regarded as the gold standard for diagnosis and evaluation of VDM [ 4 , 5 ], other imaging devices such as optical coherence tomography and scanning laser ophthalmoscope are being used for VDM [ 6 ]. Optos, an ultra-widefield imaging system utilizing a scanning laser ophthalmoscope, is capable of obtaining fundus images with a horizontal field of view of approximately 200 degrees without pupillary dilation [ 7 ]. Because eyes with acute floaters are at risk for retinal tears and detachment [ 8 ], Optos imaging is commonly used to assess the condition of vitreous and retina in VDM eyes. However, the sensitivity of Optos imaging to detect vitreous floaters is unknown. In this study, we will explore the sensitivity of Optos imaging for monitoring vitreous floaters in VDM and define the factors associated with the visibility of floaters on Optos images. Methods Patient Selection The institutional ethics committee of the He Eye Specialist Hospital gave its approval to this cross-sectional study in accordance with the Helsinki Declaration's guidelines. Following informed consent, 420 eyes from 345 patients with VDM were included in this study, which was conducted between January 2022 and August 2022, with the participants recruited from the outpatient clinics of He Eye Specialist Hospital. All patients complained of floater symptoms in either one or both eyes. Eyes with secondary vitreous floaters, such as vitreous inflammation or hemorrhage, were excluded. Eyes with images of poor quality were also excluded. Ophthalmological Examination Slit-lamp, visual acuity, intraocular pressure, refractive errors, vitreous and fundus examinations through a dilated pupil, ultrasound B scan (MD-2400S, MEDA Co., Ltd, Tianjin, China), and Optos (Optos® 200Tx, Optos®, Dunfermline, U.K.) examinations were performed on all eyes. In the ocular ultrasound B scan, the vitreous status was determined through the eyelid contact method with gel with a 10 MHz probe. The mobility of the posterior vitreous was examined during saccadic eye movements using both vertical and horizontal views. The definition of vitreous floaters is hyperechoic material that is only visible in the vitreous cavity of the eye. A PVD status was considered when the posterior vitreous cortex was well defined and completely separated from the retina (Fig. 1 ) [ 9 ]. Data Collection The baseline demographic data were collected, including age, gender, laterality of the involved eye, spherical equivalent, and duration of floater symptoms. On ultrasound B scan images, the shortest distance of floaters from the retina would be measured, and the highest reflective spots in the vitreous cavity would be chosen to measure. This distance was measured by two investigators (CS and BW), and the average value was used. The visibility of floaters on Optos images was also independently assessed by two investigators (CS and BW), and for the inconsistencies, the senior investigator (TZL) made a final decision. Statistical Analysis Continuous values were represented by the mean and standard deviation, whereas categorical variables were shown as percentages. Using the intraclass coefficient (ICC), the inter-rater agreement for the visibility of vitreous floaters on Optos images was determined. The agreement between reviewers was high: ICC = 0.971 (p < 0.001). Using univariate and multiple binary logistic regression analyses, risk factors associated with the visibility of vitreous floaters on Optos images were identified. For this study, the alpha level was set to 0.05, and the statistical power was established at 95%. All statistical analyses were performed with SPSS (SPSS Inc., USA), version 27.0. Results In total, 420 eyes from 345 VDM patients were collected for this study. The mean age of all patients was 56.19 ± 13.89 years old, with a distinct female predominance (66.67%). There were 84 (20%) eyes with emmetropia, 144 (34.29%) eyes with low and moderate myopia, 36 (8.57%) eyes with high myopia, and 156 (37.14%) eyes with hyperopia. The major type of floaters was PVD (80.95%). The vitreous floaters were visible on Optos images in only 47.62% of eyes (55.29% in eyes with PVD and 15% in eyes without PVD) (Table 1 ). Table 1 The demographic data of patients n (%) Age (yrs) <30 25(7.25) 30–39 22(6.38) 40–49 32(9.28) 50–59 108(31.30) 60–69 121(35.07) ≥ 70 37(10.72) Gender Male 115(33.33) Female 230(66.67) Refractive errors Myopia (≤-0.5D) 180(42.86) Emmetropia (-0.5D~-0.5D) 84(20.00) Hyperopia (≥ 0.5D) 156(37.14) SE(D) (mean ± SD) -1.22 ± 3.37 Duration of floater symptoms (days) (mean ± SD) 258.19 ± 1022.19 The distance of the floaters from the retina (mean ± SD) 4.38 ± 2.22 Types of floaters PVD 340(80.95) Non-PVD 80(19.05) PVD = posterior vitreous detachment In the univariate analysis, age (OR = 1.083, 95%CI = 1.061–1.104, P < 0.001), the distance of the floaters from the retina (OR = 1.181, 95%CI = 1.069–1.304, P = 0.001), and floaters of PVD type (OR = 7.009, 95%CI = 3.659–13.424, P < 0.001) were significantly correlated with the visibility of vitreous floaters on Optos images. In the multivariate binary logistic regression analysis, age (OR = 1.094, 95%CI = 1.063–1.125, P < 0.001) (Fig. 2 ), spherical equivalent (OR = 0.869, 95%CI = 0.791–0.955, P = 0.004) and the distance of the floaters from the retina (OR = 1.191, 95%CI = 1.059–1.339, P = 0.003) were significantly correlated with the visibility of vitreous floaters on Optos images (Table 2 ). Table 2 Univariate and multivariate logistic regression analysis for the risk factors associated with the visibility of floaters on Optos images Variate Univariate analysis Multivariate analysis OR (95%CI) P OR (95%CI) P Male 1.155(0.771–1.731) 0.485 1.565(0.925–2.648) 0.095 Age 1.083(1.061–1.104) <0.001 1.094(1.063–1.125) <0.001 Duration of floater symptoms 1.000(0.998–1.001) 0.486 1.000(0.998–1.001) 0.466 SE 1.009(0.953–1.068) 0.756 0.869(0.791–0.955) 0.004 The distance of the floaters from the retina 1.181(1.069–1.304) 0.001 1.191(1.059–1.339) 0.003 PVD 7.009(3.659–13.424) <0.001 2.529(0.850–7.523) 0.095 OR = odds ratio, CI = confidence interval, SE = Spherical equivalent, PVD = posterior vitreous detachment On Optos images, 25.71% of VDM eyes had additional retinal problems, such as drusen, epiretinal membrane, macular hole, peripheral retinal degeneration, choroidal nevus, Fuchs spot, diabetic retinopathy, bone-spicule-like pigmentation, and myelinated nerve fibers (Table 3 ). Table 3 The other retinal abnormalities noted on Optos images Other retinal signs noted on Optos n(%) Drusen 19(4.52) ERM 10(2.38) MH 1(0.24) Peripheral retinal degeneration 33(7.86) Lattice 4(0.95) White without pressure 15(3.57) Frost like 5(1.19) Snail like 1(0.24) Tears 8(1.90) Choroidal nevus 2(0.48) Fuchs spot 2(0.48) DR 3(0.71) Bone-spicule like pigmentation 1(0.24) Myelinated nerve fiber 4(0.95) ERM = epiretinal membrane, MH = macular hole, DR = diabetic retinopathy Discussion VDM appears to be more prevalent among women, as reported in previous studies [ 10 – 13 ], which is consistent with the results of this study. Changes in hormones during perimenopause may affect how glycosaminoglycans are made and broken down [ 14 , 15 ]. This could affect the vitreous collagen or the interface between the vitreous and the retina. Ultrasound would be able to locate condensations deeper within the vitreous, ascertain their relationship to the central visual axis, and determine their mobility. Measuring the acoustic echo of reflected sound waves as they reach tissues of varying densities is fundamental to ultrasonography. In this study, a 10 MHz probe was used, which has better sensitivity and can be used to look at low-intensity scatterers, like those in the vitreous humor, that are hard to find with a higher-frequency probe [ 16 ]. Interestingly, an ultrasound sound B scan showed high echo signals in the vitreous cavity of all VDM eyes in the present study. Obviously, not every eye with vitreous echodensity would display VDM symptoms. Nguyen et al. [ 17 ] used quantitative ultrasonography to assess the vitreous structure; they also found vitreous echodensity in the eyes without floater symptoms. Hence, just using an ultrasound sound B scan to diagnose VDM should be oversensitive. The Optos ultra-widefield imaging system is a scanning laser ophthalmoscope that can acquire widefield images at 532 nm (green) or 632 nm (red) scanning laser wavelengths. The two images may be viewed independently or superimposed to produce a semi-realistic color image. Compared to conventional imaging systems, the use of two laser wavelengths is advantageous because the red laser wavelength penetrates deeper into the retina and choroid, and the green laser wavelength produces better images of the retina's surface layers and retinal arteries. Optos imaging was reported to evaluate vitreous floaters with a sensitivity of 81.82% for PVD-type floaters and 58.62% for non-PVD-type floaters in a previous study, but that sample size was pretty small [ 12 ]. Son et al. [ 6 ] used Optos and optical coherence tomography to evaluate vitreous floaters, and peripapillary vitreous opacity was found in 62.2% of patients (122 out of 196 eyes). That result is comparable to the current study (55.29%). On Optos images, only 15% of eyes with non-PVD floaters were visible in the current study. The most frequent cause of non-PVD floaters is fibrillar aggregation, which can interfere with photon transmission sufficiently to cause long-lasting and progressive floaters [ 18 , 19 ]. These floaters typically appear as strands or tiny dots [ 18 , 19 ]. Optos imaging has difficulty projecting the shadows of these floaters on occasion. In addition, numerous variables, such as the floater's size, density, and distance from the retina, were found to be correlated with the projection of floater shadows [ 20 ]. In this study, vitreous floaters further from the retina were easier to image on Optos imaging. This may be due to the fact that floaters nearer the laser's light source cast larger shadows [ 20 ]. In the current study, vitreous floaters in greater myopic eyes were also more visible on Optos imaging. We hypothesized that the higher degree of myopia may be accompanied by more severe vitreous liquefaction, resulting in more severe vitreous opacity, thereby increasing the visibility of vitreous floaters on Optos imaging [ 5 ]. Previous studies have demonstrated that as one ages, vitreous liquefaction worsens and vitreous collagen changes [ 5 ]. The loss of type IX collagen causes more type II collagen fibers to assemble into larger fiber polymers, which may increase the visibility of vitreous floaters on Optos images. In contrast, as the population ages, PVD will account for a greater proportion. Larger floaters, like a Weiss ring or a detached hyaloid, are also simpler to find [ 5 ]. In the current study, PVD-type floaters also had a tendency to be evident on Optos images. This study has a number of limitations. Although we hypothesized that the size and density of floaters would also affect how they appear on Optos imaging, there is currently no credible way to measure them accurately [ 21 ]. Total vitreous opacity may also affect the imaging of floaters on Optos, and quantitative ultrasound may be used to assess the total vitreous opacity in the future [ 4 ]. However, so far as we know, this is the largest study that shows how well Optos imaging can find vitreous floaters in VDM. In summary, the sensitivity of Optos imaging for vitreous floaters is low, especially in non-PVD eyes, but it is a useful adjunct because it can detect numerous other retinal abnormalities that could otherwise be missed. Abbreviations VDM vision degrading myodesopsia PVD posterior vitreous detachment OR odds ratio ICC intraclass coefficient Declarations Acknowledgements Not applicable. Authors’ contributions LJS, TZL - research design, interpretation of data, critical revision of the manuscript, and final approval of the version to be published. CS, BW - data acquisition and analysis, drafting the manuscript. EEP - critical revision of the manuscript, data analysis. All authors read and approved the final manuscript. Funding Shenyang Young and Middle-aged Science and Technology Innovation Talent Support Program (RC210267). The funding organization had no role in the design or conduct of this research. Data Availability The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request. Ethics approval and consent to participate All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee (He Eye Specialist Hospital review board – (IRB (2021) K016.01) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.” Informed consent was obtained from participants to participate in the study. Consent for publication Not applicable. Conflict of interest None of the authors have any conflict of interest to declare. References Webb BF, Webb JR, Schroeder MC, North CS. Prevalence of vitreous floaters in a community sample of smartphone users. Int J Ophthalmol. 2013;6:402-5. Milston R, Madigan MC, Sebag J. Vitreous floaters: Etiology, diagnostics, and management. Surv Ophthalmol. 2016;61:211-27. Broadhead GK, Hong T, Chang AA.To Treat or Not to Treat: Management Options for Symptomatic Vitreous Floaters. Asia Pac J Ophthalmol (Phila). 2020;9:96-103. Mamou J, Wa CA, Yee KM, Silverman RH, Ketterling JA, Sadun AA, Sebag J. Ultrasound-based quantification of vitreous floaters correlates with contrast sensitivity and quality of life. Invest Ophthalmol Vis Sci. 2015;56:1611-7. Sebag J. Vitreous and Vision Degrading Myodesopsia. Prog Retin Eye Res. 2020;79:100847. Son G, Sohn J, Kong M. Acute symptomatic vitreous floaters assessed with ultra-wide field scanning laser ophthalmoscopy and spectral domain optical coherence tomography. Sci Rep. 2021;11:8930. Kumar V, Surve A, Kumawat D, Takkar B, Azad S, Chawla R, Shroff D, Arora A, Singh R, Venkatesh P. Ultra-wide field retinal imaging: A wider clinical perspective. Indian J Ophthalmol. 2021;69(4):824-35. Hollands H, Johnson D, Brox AC, lmeida D, Simel DL, Sharma. Acute-onset floaters and flashes: is this patient at risk for retinal detachment? JAMA. 2009;302(20):2243-9. Wang MD, Truong C, Mammo Z, Hussnain SA, Chen RWS. Swept Source Optical Coherence Tomography Compared to Ultrasound and Biomicroscopy for Diagnosis of Posterior Vitreous Detachment. Clin Ophthalmol. 2021;15:507-12. Shah CP, Heier JS. YAG Laser Vitreolysis vs Sham YAG Vitreolysis for Symptomatic Vitreous Floaters: A Randomized Clinical Trial. JAMA Ophthalmol. 2017;135:918-23. Ludwig GD, Gemelli H, Nunes GM, Serracarbassa PD, Zanotele M. Efficacy and safety of Nd:YAG laser vitreolysis for symptomatic vitreous floaters: A randomized controlled trial. Eur J Ophthalmol. 2021;31:909-14. Lin T, Li T, Zhang X, Hui Y, Moutari S, Pazo EE, Dai G, Shen L. The Efficacy and Safety of YAG Laser Vitreolysis for Symptomatic Vitreous Floaters of Complete PVD or Non-PVD. Ophthalmol Ther. 2022;11:201-14. Souza CE, Lima LH, Nascimento H, Zett C, Belfort R Jr. Objective assessment of YAG laser vitreolysis in patients with symptomatic vitreous floaters. Int J Retina Vitreous. 2020;6:1. Smith TJ. Dexamethasone regulation of glycosaminoglycan synthesis in cultured human skin fibroblasts. Similar effects of glucocorticoid and thyroid hormones. J Clin Invest. 1984;74:2157-63. Smith TJ, Murata Y, Horwitz AL, Philipson L, Refetoff S. Regulation of glycosaminoglycan synthesis by thyroid hormone in vitro. J Clin Invest. 1982;70:1066-73. Hewick SA, Fairhead AC, Culy JC, Atta HR. A comparison of 10 MHz and 20 MHz ultrasound probes in imaging the eye and orbit. Br J Ophthalmol. 2004;88:551-5. Nguyen JH, Nguyen-Cuu J, Yu F, Yee KM, Mamou J, Silverman RH, Ketterling J, Sebag J. Assessment of Vitreous Structure and Visual Function after Neodymium:Yttrium-Aluminum-Garnet Laser Vitreolysis. Ophthalmology. 2019;126:1517-26. Sendrowski DP, Bronstein MA. Current treatment for vitreous floaters. Optometry. 2010;81:157-61. Sebag J. Floaters and the quality of life. Am J Ophthalmol. 2011;152:3-4.e1. Serpetopoulos CN, Korakitis RA. An optical explanation of the entoptic phenomenon of 'clouds' in posterior vitreous detachment. Ophthalmic Physiol Opt. 1998;18:446-51. de Smet MD, Gad Elkareem AM, Zwinderman AH. The vitreous, the retinal interface in ocular health and disease. Ophthalmologica. 2013;230:165-78. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 20 Oct, 2023 Read the published version in BMC Ophthalmology → Version 1 posted Editorial decision: Major revision 18 Sep, 2023 Reviews received at journal 10 Sep, 2023 Reviewers agreed at journal 08 Sep, 2023 Reviewers invited by journal 05 Sep, 2023 Editor assigned by journal 04 Sep, 2023 Submission checks completed at journal 24 Aug, 2023 First submitted to journal 21 Aug, 2023 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-3281891","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":228640655,"identity":"c4bd2db8-c5f0-4ff2-ba6f-56059ca8a2e9","order_by":0,"name":"Tiezhu Lin","email":"","orcid":"","institution":"Zhejiang Provincial People’s Hospital","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Tiezhu","middleName":"","lastName":"Lin","suffix":""},{"id":228640656,"identity":"8fbeb246-9c06-4f0d-8cd2-cf1f3251b632","order_by":1,"name":"Cheng Shi","email":"","orcid":"","institution":"He Eye Specialist Hospital","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Cheng","middleName":"","lastName":"Shi","suffix":""},{"id":228640657,"identity":"93cdf052-8aba-4744-a51a-67be886e95be","order_by":2,"name":"Bing Wu","email":"","orcid":"","institution":"He Eye Specialist Hospital","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Bing","middleName":"","lastName":"Wu","suffix":""},{"id":228640658,"identity":"8aaef337-ee1f-49f4-8ee1-fdb3e5619ede","order_by":3,"name":"Emmanuel Eric Pazo","email":"","orcid":"","institution":"He Eye Specialist Hospital","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Emmanuel","middleName":"Eric","lastName":"Pazo","suffix":""},{"id":228640659,"identity":"4744f468-2da4-44a4-9471-31f6526cf86a","order_by":4,"name":"Lijun Shen","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA1ElEQVRIiWNgGAWjYDACdobEBwwMEjIkaGFmSDYAauEhSQubBJAiQYt8M8Ozqhs1FjwM7D2GDxhq7Bj4Zzfg12JwmCHtds4xoMN4zhgbMBxLZpC4c4CAFmaQFjagFokcMwkGtgMMBhIJBB2WVpzzD6hF/o35D4Z/RGhhADqMObcNZAuPGQNjGxFagH5Jls7tk+Bh40krlkjsS+aRuEHIYe09iZ9zvtXJ8bMf3vjhwzc7Of4ZhBzGwANRwcbAYcCQQFwEsR+AMR4QoXoUjIJRMApGIgAAZKA086/PHKkAAAAASUVORK5CYII=","orcid":"","institution":"Zhejiang Provincial People’s Hospital","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Lijun","middleName":"","lastName":"Shen","suffix":""}],"badges":[],"createdAt":"2023-08-21 09:29:26","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-3281891/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-3281891/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12886-023-03166-y","type":"published","date":"2023-10-20T15:01:32+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":42310081,"identity":"d9911c4f-02e6-4c99-8564-60c1c725d863","added_by":"auto","created_at":"2023-08-29 14:27:31","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":3315438,"visible":true,"origin":"","legend":"\u003cp\u003ePVD noted on Ultrasound B scan and Optos images. The hyperreflective ring (blue arrow) in the vitreous cavity on the ultrasound B scan is suggestive of a Weiss ring (A), with the visible Weiss ring (blue arrow) noted on the Optos images (B). The hyperreflective line (blue arrow) in the vitreous cavity on the ultrasound B scan is suggestive of a detached hyaloid membrane (C), with the visible detached membrane (blue arrow) appearing on the Optos images (D).\u003c/p\u003e","description":"","filename":"Figure1.png","url":"https://assets-eu.researchsquare.com/files/rs-3281891/v1/2a9bc10efce3de97116fdd22.png"},{"id":42309467,"identity":"7f33a103-74b2-4fb7-8057-c921c87d4daf","added_by":"auto","created_at":"2023-08-29 14:19:31","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":64685,"visible":true,"origin":"","legend":"\u003cp\u003eThe sensitivity of Optos imaging for VDM with different age groups.\u003c/p\u003e","description":"","filename":"Figure2.png","url":"https://assets-eu.researchsquare.com/files/rs-3281891/v1/5f359aa5535de63690d926a3.png"},{"id":45091335,"identity":"592328dd-3f73-4a7d-8de1-630cc7d7c05e","added_by":"auto","created_at":"2023-10-23 15:09:34","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1899634,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-3281891/v1/048ede6a-023e-453c-a8fc-ad91004ae65f.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Vision degrading myodesopsia assessed with Optos ultra-widefield scanning laser ophthalmoscope","fulltext":[{"header":"Introduction","content":"\u003cp\u003eVDM affects an increasing number of adults due to the global prevalence of myopia and the aging of the population [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. As the eyes move, VDM may manifest as spots, cobwebs, shadows, and other diverse forms [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. While floaters are typically only a minor annoyance, some eyes develop numerous symptomatic vitreous opacities that significantly impede reading, driving, and other daily visual activities. VDM can be diagnosed with a dilated fundus exam and/or an ultrasound B scan. Although the ultrasound B scan is regarded as the gold standard for diagnosis and evaluation of VDM [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e], other imaging devices such as optical coherence tomography and scanning laser ophthalmoscope are being used for VDM [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Optos, an ultra-widefield imaging system utilizing a scanning laser ophthalmoscope, is capable of obtaining fundus images with a horizontal field of view of approximately 200 degrees without pupillary dilation [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. Because eyes with acute floaters are at risk for retinal tears and detachment [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e], Optos imaging is commonly used to assess the condition of vitreous and retina in VDM eyes. However, the sensitivity of Optos imaging to detect vitreous floaters is unknown. In this study, we will explore the sensitivity of Optos imaging for monitoring vitreous floaters in VDM and define the factors associated with the visibility of floaters on Optos images.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003ePatient Selection\u003c/h2\u003e \u003cp\u003e The institutional ethics committee of the He Eye Specialist Hospital gave its approval to this cross-sectional study in accordance with the Helsinki Declaration's guidelines. Following informed consent, 420 eyes from 345 patients with VDM were included in this study, which was conducted between January 2022 and August 2022, with the participants recruited from the outpatient clinics of He Eye Specialist Hospital. All patients complained of floater symptoms in either one or both eyes. Eyes with secondary vitreous floaters, such as vitreous inflammation or hemorrhage, were excluded. Eyes with images of poor quality were also excluded.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eOphthalmological Examination\u003c/h2\u003e \u003cp\u003eSlit-lamp, visual acuity, intraocular pressure, refractive errors, vitreous and fundus examinations through a dilated pupil, ultrasound B scan (MD-2400S, MEDA Co., Ltd, Tianjin, China), and Optos (Optos\u0026reg; 200Tx, Optos\u0026reg;, Dunfermline, U.K.) examinations were performed on all eyes. In the ocular ultrasound B scan, the vitreous status was determined through the eyelid contact method with gel with a 10 MHz probe. The mobility of the posterior vitreous was examined during saccadic eye movements using both vertical and horizontal views. The definition of vitreous floaters is hyperechoic material that is only visible in the vitreous cavity of the eye. A PVD status was considered when the posterior vitreous cortex was well defined and completely separated from the retina (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e) [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e].\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eData Collection\u003c/h2\u003e \u003cp\u003eThe baseline demographic data were collected, including age, gender, laterality of the involved eye, spherical equivalent, and duration of floater symptoms. On ultrasound B scan images, the shortest distance of floaters from the retina would be measured, and the highest reflective spots in the vitreous cavity would be chosen to measure. This distance was measured by two investigators (CS and BW), and the average value was used. The visibility of floaters on Optos images was also independently assessed by two investigators (CS and BW), and for the inconsistencies, the senior investigator (TZL) made a final decision.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eStatistical Analysis\u003c/h2\u003e \u003cp\u003eContinuous values were represented by the mean and standard deviation, whereas categorical variables were shown as percentages. Using the intraclass coefficient (ICC), the inter-rater agreement for the visibility of vitreous floaters on Optos images was determined. The agreement between reviewers was high: ICC\u0026thinsp;=\u0026thinsp;0.971 (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Using univariate and multiple binary logistic regression analyses, risk factors associated with the visibility of vitreous floaters on Optos images were identified. For this study, the alpha level was set to 0.05, and the statistical power was established at 95%. All statistical analyses were performed with SPSS (SPSS Inc., USA), version 27.0.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eIn total, 420 eyes from 345 VDM patients were collected for this study. The mean age of all patients was 56.19\u0026thinsp;\u0026plusmn;\u0026thinsp;13.89 years old, with a distinct female predominance (66.67%). There were 84 (20%) eyes with emmetropia, 144 (34.29%) eyes with low and moderate myopia, 36 (8.57%) eyes with high myopia, and 156 (37.14%) eyes with hyperopia. The major type of floaters was PVD (80.95%). The vitreous floaters were visible on Optos images in only 47.62% of eyes (55.29% in eyes with PVD and 15% in eyes without PVD) (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThe demographic data of patients\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge (yrs)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e25(7.25)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e30\u0026ndash;39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e22(6.38)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e40\u0026ndash;49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e32(9.28)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e50\u0026ndash;59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e108(31.30)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e60\u0026ndash;69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e121(35.07)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e37(10.72)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eGender\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e115(33.33)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e230(66.67)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eRefractive errors\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMyopia (\u0026le;-0.5D)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e180(42.86)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmmetropia (-0.5D~-0.5D)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e84(20.00)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHyperopia (\u0026ge;\u0026thinsp;0.5D)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e156(37.14)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSE(D) (mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-1.22\u0026thinsp;\u0026plusmn;\u0026thinsp;3.37\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDuration of floater symptoms (days) (mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e258.19\u0026thinsp;\u0026plusmn;\u0026thinsp;1022.19\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eThe distance of the floaters from the retina (mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4.38\u0026thinsp;\u0026plusmn;\u0026thinsp;2.22\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTypes of floaters\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePVD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e340(80.95)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNon-PVD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e80(19.05)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"2\"\u003ePVD\u0026thinsp;=\u0026thinsp;posterior vitreous detachment\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eIn the univariate analysis, age (OR\u0026thinsp;=\u0026thinsp;1.083, 95%CI\u0026thinsp;=\u0026thinsp;1.061\u0026ndash;1.104, P\u0026thinsp;\u0026lt;\u0026thinsp;0.001), the distance of the floaters from the retina (OR\u0026thinsp;=\u0026thinsp;1.181, 95%CI\u0026thinsp;=\u0026thinsp;1.069\u0026ndash;1.304, P\u0026thinsp;=\u0026thinsp;0.001), and floaters of PVD type (OR\u0026thinsp;=\u0026thinsp;7.009, 95%CI\u0026thinsp;=\u0026thinsp;3.659\u0026ndash;13.424, P\u0026thinsp;\u0026lt;\u0026thinsp;0.001) were significantly correlated with the visibility of vitreous floaters on Optos images. In the multivariate binary logistic regression analysis, age (OR\u0026thinsp;=\u0026thinsp;1.094, 95%CI\u0026thinsp;=\u0026thinsp;1.063\u0026ndash;1.125, P\u0026thinsp;\u0026lt;\u0026thinsp;0.001) (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e), spherical equivalent (OR\u0026thinsp;=\u0026thinsp;0.869, 95%CI\u0026thinsp;=\u0026thinsp;0.791\u0026ndash;0.955, P\u0026thinsp;=\u0026thinsp;0.004) and the distance of the floaters from the retina (OR\u0026thinsp;=\u0026thinsp;1.191, 95%CI\u0026thinsp;=\u0026thinsp;1.059\u0026ndash;1.339, P\u0026thinsp;=\u0026thinsp;0.003) were significantly correlated with the visibility of vitreous floaters on Optos images (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eUnivariate and multivariate logistic regression analysis for the risk factors associated with the visibility of floaters on Optos images\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariate\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eUnivariate analysis\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003eMultivariate analysis\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOR (95%CI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eOR (95%CI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.155(0.771\u0026ndash;1.731)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.485\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.565(0.925\u0026ndash;2.648)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.095\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.083(1.061\u0026ndash;1.104)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.094(1.063\u0026ndash;1.125)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDuration of floater symptoms\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.000(0.998\u0026ndash;1.001)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.486\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.000(0.998\u0026ndash;1.001)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.466\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSE\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.009(0.953\u0026ndash;1.068)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.756\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.869(0.791\u0026ndash;0.955)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.004\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThe distance of the floaters from the retina\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.181(1.069\u0026ndash;1.304)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.191(1.059\u0026ndash;1.339)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.003\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePVD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e7.009(3.659\u0026ndash;13.424)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.529(0.850\u0026ndash;7.523)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.095\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003eOR\u0026thinsp;=\u0026thinsp;odds ratio, CI\u0026thinsp;=\u0026thinsp;confidence interval, SE\u0026thinsp;=\u0026thinsp;Spherical equivalent, PVD\u0026thinsp;=\u0026thinsp;posterior vitreous detachment\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eOn Optos images, 25.71% of VDM eyes had additional retinal problems, such as drusen, epiretinal membrane, macular hole, peripheral retinal degeneration, choroidal nevus, Fuchs spot, diabetic retinopathy, bone-spicule-like pigmentation, and myelinated nerve fibers (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThe other retinal abnormalities noted on Optos images\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther retinal signs noted on Optos\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003en(%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDrusen\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e19(4.52)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eERM\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e10(2.38)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMH\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1(0.24)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePeripheral retinal degeneration\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e33(7.86)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLattice\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4(0.95)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWhite without pressure\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e15(3.57)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFrost like\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5(1.19)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSnail like\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1(0.24)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTears\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e8(1.90)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eChoroidal nevus\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2(0.48)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eFuchs spot\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2(0.48)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDR\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3(0.71)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eBone-spicule like pigmentation\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1(0.24)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMyelinated nerve fiber\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4(0.95)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"2\"\u003eERM\u0026thinsp;=\u0026thinsp;epiretinal membrane, MH\u0026thinsp;=\u0026thinsp;macular hole, DR\u0026thinsp;=\u0026thinsp;diabetic retinopathy\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eVDM appears to be more prevalent among women, as reported in previous studies [\u003cspan additionalcitationids=\"CR11 CR12\" citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e], which is consistent with the results of this study. Changes in hormones during perimenopause may affect how glycosaminoglycans are made and broken down [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. This could affect the vitreous collagen or the interface between the vitreous and the retina.\u003c/p\u003e \u003cp\u003eUltrasound would be able to locate condensations deeper within the vitreous, ascertain their relationship to the central visual axis, and determine their mobility. Measuring the acoustic echo of reflected sound waves as they reach tissues of varying densities is fundamental to ultrasonography. In this study, a 10 MHz probe was used, which has better sensitivity and can be used to look at low-intensity scatterers, like those in the vitreous humor, that are hard to find with a higher-frequency probe [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. Interestingly, an ultrasound sound B scan showed high echo signals in the vitreous cavity of all VDM eyes in the present study. Obviously, not every eye with vitreous echodensity would display VDM symptoms. Nguyen et al. [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e] used quantitative ultrasonography to assess the vitreous structure; they also found vitreous echodensity in the eyes without floater symptoms. Hence, just using an ultrasound sound B scan to diagnose VDM should be oversensitive.\u003c/p\u003e \u003cp\u003eThe Optos ultra-widefield imaging system is a scanning laser ophthalmoscope that can acquire widefield images at 532 nm (green) or 632 nm (red) scanning laser wavelengths. The two images may be viewed independently or superimposed to produce a semi-realistic color image. Compared to conventional imaging systems, the use of two laser wavelengths is advantageous because the red laser wavelength penetrates deeper into the retina and choroid, and the green laser wavelength produces better images of the retina's surface layers and retinal arteries. Optos imaging was reported to evaluate vitreous floaters with a sensitivity of 81.82% for PVD-type floaters and 58.62% for non-PVD-type floaters in a previous study, but that sample size was pretty small [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. Son et al. [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e] used Optos and optical coherence tomography to evaluate vitreous floaters, and peripapillary vitreous opacity was found in 62.2% of patients (122 out of 196 eyes). That result is comparable to the current study (55.29%). On Optos images, only 15% of eyes with non-PVD floaters were visible in the current study. The most frequent cause of non-PVD floaters is fibrillar aggregation, which can interfere with photon transmission sufficiently to cause long-lasting and progressive floaters [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. These floaters typically appear as strands or tiny dots [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. Optos imaging has difficulty projecting the shadows of these floaters on occasion. In addition, numerous variables, such as the floater's size, density, and distance from the retina, were found to be correlated with the projection of floater shadows [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. In this study, vitreous floaters further from the retina were easier to image on Optos imaging. This may be due to the fact that floaters nearer the laser's light source cast larger shadows [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. In the current study, vitreous floaters in greater myopic eyes were also more visible on Optos imaging. We hypothesized that the higher degree of myopia may be accompanied by more severe vitreous liquefaction, resulting in more severe vitreous opacity, thereby increasing the visibility of vitreous floaters on Optos imaging [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. Previous studies have demonstrated that as one ages, vitreous liquefaction worsens and vitreous collagen changes [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. The loss of type IX collagen causes more type II collagen fibers to assemble into larger fiber polymers, which may increase the visibility of vitreous floaters on Optos images. In contrast, as the population ages, PVD will account for a greater proportion. Larger floaters, like a Weiss ring or a detached hyaloid, are also simpler to find [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. In the current study, PVD-type floaters also had a tendency to be evident on Optos images.\u003c/p\u003e \u003cp\u003eThis study has a number of limitations. Although we hypothesized that the size and density of floaters would also affect how they appear on Optos imaging, there is currently no credible way to measure them accurately [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. Total vitreous opacity may also affect the imaging of floaters on Optos, and quantitative ultrasound may be used to assess the total vitreous opacity in the future [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. However, so far as we know, this is the largest study that shows how well Optos imaging can find vitreous floaters in VDM.\u003c/p\u003e \u003cp\u003eIn summary, the sensitivity of Optos imaging for vitreous floaters is low, especially in non-PVD eyes, but it is a useful adjunct because it can detect numerous other retinal abnormalities that could otherwise be missed.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eVDM \u0026nbsp; \u0026nbsp; \u0026nbsp;vision degrading myodesopsia\u003c/p\u003e\n\u003cp\u003ePVD \u0026nbsp; \u0026nbsp; \u0026nbsp; posterior vitreous detachment\u003c/p\u003e\n\u003cp\u003eOR \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; odds ratio\u003c/p\u003e\n\u003cp\u003eICC \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;intraclass coefficient\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eLJS, TZL - research design, interpretation of data, critical revision of the manuscript, and final approval of the version to be published.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eCS, BW - data acquisition and analysis, drafting the manuscript.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eEEP - critical revision of the manuscript, data analysis. All authors read and approved the final manuscript.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eShenyang Young and Middle-aged Science and Technology Innovation Talent Support Program (RC210267). The funding organization had no role in the design or conduct of this research.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Availability\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee (He Eye Specialist Hospital review board \u0026ndash; (IRB (2021) K016.01) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.\u0026rdquo; Informed consent was obtained from participants to participate in the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflict of interest\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNone of the authors have any conflict of interest to declare.\u0026nbsp;\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eWebb BF, Webb JR, Schroeder MC, North CS. Prevalence of vitreous floaters in a community sample of smartphone users. Int J Ophthalmol. 2013;6:402-5. \u003c/li\u003e\n\u003cli\u003eMilston R, Madigan MC, Sebag J. Vitreous floaters: Etiology, diagnostics, and management. Surv Ophthalmol. 2016;61:211-27.\u003c/li\u003e\n\u003cli\u003eBroadhead GK, Hong T, Chang AA.To Treat or Not to Treat: Management Options for Symptomatic Vitreous Floaters. Asia Pac J Ophthalmol (Phila). 2020;9:96-103. \u003c/li\u003e\n\u003cli\u003eMamou J, Wa CA, Yee KM, Silverman RH, Ketterling JA, Sadun AA, Sebag J. Ultrasound-based quantification of vitreous floaters correlates with contrast sensitivity and quality of life. Invest Ophthalmol Vis Sci. 2015;56:1611-7.\u003c/li\u003e\n\u003cli\u003eSebag J. Vitreous and Vision Degrading Myodesopsia. Prog Retin Eye Res. 2020;79:100847.\u003c/li\u003e\n\u003cli\u003eSon G, Sohn J, Kong M. Acute symptomatic vitreous floaters assessed with ultra-wide field scanning laser ophthalmoscopy and spectral domain optical coherence tomography. Sci Rep. 2021;11:8930. \u003c/li\u003e\n\u003cli\u003eKumar V, Surve A, Kumawat D, Takkar B, Azad S, Chawla R, Shroff D, Arora A, Singh R, Venkatesh P. Ultra-wide field retinal imaging: A wider clinical perspective. Indian J Ophthalmol. 2021;69(4):824-35.\u003c/li\u003e\n\u003cli\u003eHollands H, Johnson D, Brox AC, lmeida D, Simel DL, Sharma. Acute-onset floaters and flashes: is this patient at risk for retinal detachment? JAMA. 2009;302(20):2243-9.\u003c/li\u003e\n\u003cli\u003eWang MD, Truong C, Mammo Z, Hussnain SA, Chen RWS. Swept Source Optical Coherence Tomography Compared to Ultrasound and Biomicroscopy for Diagnosis of Posterior Vitreous Detachment. Clin Ophthalmol. 2021;15:507-12. \u003c/li\u003e\n\u003cli\u003eShah CP, Heier JS. YAG Laser Vitreolysis vs Sham YAG Vitreolysis for Symptomatic Vitreous Floaters: A Randomized Clinical Trial. JAMA Ophthalmol. 2017;135:918-23.\u003c/li\u003e\n\u003cli\u003eLudwig GD, Gemelli H, Nunes GM, Serracarbassa PD, Zanotele M. Efficacy and safety of Nd:YAG laser vitreolysis for symptomatic vitreous floaters: A randomized controlled trial. Eur J Ophthalmol. 2021;31:909-14. \u003c/li\u003e\n\u003cli\u003eLin T, Li T, Zhang X, Hui Y, Moutari S, Pazo EE, Dai G, Shen L. The Efficacy and Safety of YAG Laser Vitreolysis for Symptomatic Vitreous Floaters of Complete PVD or Non-PVD. Ophthalmol Ther. 2022;11:201-14.\u003c/li\u003e\n\u003cli\u003eSouza CE, Lima LH, Nascimento H, Zett C, Belfort R Jr. Objective assessment of YAG laser vitreolysis in patients with symptomatic vitreous floaters. Int J Retina Vitreous. 2020;6:1. \u003c/li\u003e\n\u003cli\u003eSmith TJ. Dexamethasone regulation of glycosaminoglycan synthesis in cultured human skin fibroblasts. Similar effects of glucocorticoid and thyroid hormones. J Clin Invest. 1984;74:2157-63. \u003c/li\u003e\n\u003cli\u003eSmith TJ, Murata Y, Horwitz AL, Philipson L, Refetoff S. Regulation of glycosaminoglycan synthesis by thyroid hormone in vitro. J Clin Invest. 1982;70:1066-73.\u003c/li\u003e\n\u003cli\u003eHewick SA, Fairhead AC, Culy JC, Atta HR. A comparison of 10 MHz and 20 MHz ultrasound probes in imaging the eye and orbit. Br J Ophthalmol. 2004;88:551-5.\u003c/li\u003e\n\u003cli\u003eNguyen JH, Nguyen-Cuu J, Yu F, Yee KM, Mamou J, Silverman RH, Ketterling J, Sebag J. Assessment of Vitreous Structure and Visual Function after Neodymium:Yttrium-Aluminum-Garnet Laser Vitreolysis. Ophthalmology. 2019;126:1517-26. \u003c/li\u003e\n\u003cli\u003eSendrowski DP, Bronstein MA. Current treatment for vitreous floaters. Optometry. 2010;81:157-61. \u003c/li\u003e\n\u003cli\u003eSebag J. Floaters and the quality of life. Am J Ophthalmol. 2011;152:3-4.e1.\u003c/li\u003e\n\u003cli\u003eSerpetopoulos CN, Korakitis RA. An optical explanation of the entoptic phenomenon of \u0026apos;clouds\u0026apos; in posterior vitreous detachment. Ophthalmic Physiol Opt. 1998;18:446-51. \u003c/li\u003e\n\u003cli\u003ede Smet MD, Gad Elkareem AM, Zwinderman AH. The vitreous, the retinal interface in ocular health and disease. Ophthalmologica. 2013;230:165-78. \u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-ophthalmology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"boph","sideBox":"Learn more about [BMC Ophthalmology](http://bmcophthalmol.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/boph","title":"BMC Ophthalmology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Floaters, Optos, vision degrading myodesopsia, scanning laser ophthalmoscope","lastPublishedDoi":"10.21203/rs.3.rs-3281891/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-3281891/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eTo investigate the diagnostic sensitivity of Optos imaging for vision degrading myodesopsia (VDM).\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eA total of 420 eyes from 345 patients with VDM were collected in this cross-sectional study. All eyes were classified as having posterior vitreous detachment (PVD) or not having PVD. The sensitivity of Optos imaging for the visibility of vitreous floaters was evaluated. The associated factors with the visibility of vitreous floaters on Optos images were analyzed in univariate and multivariate logistic regression analyses.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eThe mean age of all patients was 56.19\u0026thinsp;\u0026plusmn;\u0026thinsp;13.89 years old, and 66.67% of patients were female. The vitreous floaters were visible on the ultrasound B scan in all eyes, but only in 47.62% of Optos images (55.29% in eyes with PVD and 15% in eyes without PVD). In the multiple binary logistic regression analysis, age (OR\u0026thinsp;=\u0026thinsp;1.094, 95%CI\u0026thinsp;=\u0026thinsp;1.063\u0026ndash;1.125, P\u0026thinsp;\u0026lt;\u0026thinsp;0.001), spherical equivalent (OR\u0026thinsp;=\u0026thinsp;0.869, 95%CI\u0026thinsp;=\u0026thinsp;0.791\u0026ndash;0.955, P\u0026thinsp;=\u0026thinsp;0.004) and the distance of the floaters from the retina (OR\u0026thinsp;=\u0026thinsp;1.191, 95%CI\u0026thinsp;=\u0026thinsp;1.059\u0026ndash;1.339, P\u0026thinsp;=\u0026thinsp;0.003) were significantly correlated with the visibility of vitreous floaters on Optos images. On Optos images, 25.71% of VDM eyes presented additional retinal abnormalities.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eOptos imaging has a low sensitivity for vitreous floaters, particularly in eyes without PVD. On Optos imaging, floaters were more visible in older patients, eyes with greater myopia, and floaters that were further from the retina.\u003c/p\u003e","manuscriptTitle":"Vision degrading myodesopsia assessed with Optos ultra-widefield scanning laser ophthalmoscope","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2023-08-29 14:19:27","doi":"10.21203/rs.3.rs-3281891/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Major revision","date":"2023-09-19T00:59:41+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2023-09-10T12:46:40+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"51876f5e-338e-4368-bf09-44facd3a2b55","date":"2023-09-08T22:04:43+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2023-09-05T20:44:52+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2023-09-05T03:02:22+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2023-08-24T12:41:44+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Ophthalmology","date":"2023-08-21T09:21:16+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-ophthalmology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"boph","sideBox":"Learn more about [BMC Ophthalmology](http://bmcophthalmol.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/boph","title":"BMC Ophthalmology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"798cbc02-25a8-4969-8a79-295a2d909353","owner":[],"postedDate":"August 29th, 2023","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2023-10-23T15:08:09+00:00","versionOfRecord":{"articleIdentity":"rs-3281891","link":"https://doi.org/10.1186/s12886-023-03166-y","journal":{"identity":"bmc-ophthalmology","isVorOnly":false,"title":"BMC Ophthalmology"},"publishedOn":"2023-10-20 15:01:32","publishedOnDateReadable":"October 20th, 2023"},"versionCreatedAt":"2023-08-29 14:19:27","video":"","vorDoi":"10.1186/s12886-023-03166-y","vorDoiUrl":"https://doi.org/10.1186/s12886-023-03166-y","workflowStages":[]},"version":"v1","identity":"rs-3281891","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-3281891","identity":"rs-3281891","version":["v1"]},"buildId":"WrCJVZZCHTDjtuVLN7oU0","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}