In asteroid hyalosis, minute white opacities composed of calcium-containing phospholipids are found in the otherwise normal vitreous (Fig 17-12). Clinical studies have confirmed a relationship between asteroid hyalosis and both diabetes mellitus and hypertension. Asteroid hyalosis has an overall incidence of 1 in 200 persons, most frequently in people older than 50 years. The condition is unilateral in 75% of cases, and significant decreases in visual acuity are rare. When PVD occurs, compression of the material occurs and visual acuity may decrease. When asteroid hyalosis blocks the view of the posterior fundus and retinal pathology is suspected, FA is usually successful in imaging the abnormalities. Occasionally, vitrectomy may be necessary to remove visually significant opacities or to facilitate treatment of underlying retinal abnormalities such as proliferative retinopathy. Many eyes with asteroid hyalosis have an abnormal vitreoretinal interface with unusual vitreoretinal adhesions. These adhesions increase the risk of retinal break formation during vitrectomy surgery.
Figure 17-12 Color fundus photograph of asteroid hyalosis.
(Courtesy of Hermann D. Schubert, MD.)
Mochizuki Y, Hata Y, Kita T, et al. Anatomical findings of vitreoretinal interface in eyes with asteroid hyalosis. Graefes Arch Clin Exp Ophthalmol. 2009;247(9):1173–1177.
Excerpted from BCSC 2020-2021 series: Section 10 - Glaucoma. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.