In vivo imaging of the fibrillar architecture of the posterior vitreous and its relationship to the premacular bursa, Cloquet’s canal, prevascular vitreous fissures, and cisterns

  • Orly Gal-Or
  • Quraish Ghadiali
  • Rosa Dolz-Marco
  • Michael Engelbert
Retinal Disorders



To describe the fibrillar architecture of the posterior cortical vitreous and identify variations across eyes of different axial lengths in vivo.


Sixty-four eyes of 32 subjects were examined with swept-source optical coherence tomography (SS-OCT). Grading of vitreous degeneration, presence of vitreous cisterns/lacunae, posterior hyaloid status, directionality of vitreous fibers and their relations to vitreous spaces, and lamellar reflectivity of the posterior vitreous were assessed.


A consistent pattern of fibrillar organization was discovered. Eyewall parallel fibers formed a dense meshwork over the retinal surface and fibers oriented in a perpendicular fashion to this meshwork were found to envelop the various vitreous spaces, intersecting at variable angles of insertion to the eyewall parallel fibers. Lamellar reflectivity suggestive of splitting of the cortical fibrillar meshwork was detected in 27 eyes (42%) with 56% of these eyes demonstrating perpendicularly oriented intersecting fibers. Fifty-six percent of eyes with lamellar reflectivity had an axial length > 25 mm.


SS-OCT imaging revealed fibrillar organization of the posterior vitreous. Eye wall parallel hyperreflectivity of cortical vitreous was a universal finding. This pattern is suggestive of a splitting of cortical vitreous tissue and may represent a precursor to vitreoschisis. Perpendicular fibers appear to be important constituents of the walls of the various liquid vitreous spaces.


Vitreous anatomy Premacular bursa Vitreous cisterns Prevascular vitreous fissures Axial length Fibrillar architecture Lamellar reflectivity Posterior cortical vitreous Swept-source optical coherence tomography 



We appreciate the work of Camila Engelbert for the schematic illustration.


This research was supported by the Macula Foundation, Inc. The funding organization played no role in the design or conduct of this study.

Compliance with ethical standards

Conflict of interest

R. Dolz-Marco is supported by research grants from Alcon, Allergan, Bayer, Genentech, Heidelberg Engineering, Novartis and Thea Author. M. Engelbert consultant to Bayer and Genentech. O.Gal-Or and Q. Ghadiali declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Institutional review board approval was obtained through the Western Institutional Review Board. This study complied with the Health Insurance Portability and Accountability Act and adhered to the tenets of the Declaration of Helsinki.

Informed consent

Informed consent was obtained from all individual participants included in the study.


  1. 1.
    Schaal KB, Pang CE, Pozzoni MC, Engelbert M (2014) The premacular bursa’s shape revealed in vivo by swept-source optical coherence tomography. Ophthalmology 121(5):1020–1028CrossRefGoogle Scholar
  2. 2.
    Pang CE, Schaal KB, Engelbert M (2015) Association of prevascular vitreous fissures and cisterns with vitreous degeneration as assessed by swept source optical coherence tomography. Retina 35(9):1875–1882CrossRefGoogle Scholar
  3. 3.
    Vaz-Pereira S, Dansingani KK, Chen KC, Cooney MJ, Klancnik JM Jr, Engelbert M (2017) Tomographic relationships between retinal neovascularization and the posterior vitreous in proliferative diabetic retinopathy. Retina 37(7):1287–1296CrossRefGoogle Scholar
  4. 4.
    Johnson MW (2010) Posterior vitreous detachment: evolution and complications of its early stages. Am J Ophthalmol 149(3):371–382 e371CrossRefGoogle Scholar
  5. 5.
    Liu JJ, Witkin AJ, Adhi M et al (2014) Enhanced vitreous imaging in healthy eyes using swept source optical coherence tomography. PLoS One 18(7):9Google Scholar
  6. 6.
    Itakura H, Kishi S, Li D, Akiyama H (2015) En face imaging of posterior precortical vitreous pockets using swept-source optical coherence tomography. Invest Ophthalmol Vis Sci 56(5):2898–2900CrossRefGoogle Scholar
  7. 7.
    Spaide RF (2014) Visualization of the posterior vitreous with dynamic focusing and windowed averaging swept source optical coherence tomography. Am J Ophthalmol 158(6):1267–1274CrossRefGoogle Scholar
  8. 8.
    Gupta P, Yee KM, Garcia P, Rosen RB, Parikh J, Hageman GS, Sadun AA, Sebag J (2011) Vitreoschisis in macular diseases. Br J Ophthalmol 95(3):376–380CrossRefGoogle Scholar
  9. 9.
    Sebag J (2014) Vitreous in health and disease. Springer, New YorkGoogle Scholar
  10. 10.
    Itakura H, Kishi S, Li D, Nitta K, Akiyama H (2014) Vitreous changes in high myopia observed by swept-source optical coherence tomography. Invest Ophthalmol Vis Sci 55(3):1447–1452CrossRefGoogle Scholar
  11. 11.
    Sebag J (2004) Anomalous posterior vitreous detachment: a unifying concept in vitreo-retinal disease. Graefes Arch Clin Exp Ophthalmol 242(8):690–698CrossRefGoogle Scholar
  12. 12.
    Itakura H, Kishi S (2011) Aging changes of vitreomacular interface. Retina 31(7):1400–1404CrossRefGoogle Scholar
  13. 13.
    Hogan MJA, A J, Weddell JE (1971) Histology of the human eye: an atlas and textbook. W. B. Saunders Company, PhiladelphiaGoogle Scholar
  14. 14.
    Fine HF, Spaide RF (2006) Visualization of the posterior precortical vitreous pocket in vivo with triamcinolone. Arch Ophthalmol 124(11):1663CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Orly Gal-Or
    • 1
    • 2
    • 3
  • Quraish Ghadiali
    • 1
    • 2
    • 4
  • Rosa Dolz-Marco
    • 1
    • 2
    • 5
  • Michael Engelbert
    • 1
    • 2
    • 4
  1. 1.Vitreous Retina Macula Consultants of New YorkNew YorkUSA
  2. 2.LuEsther T. Mertz Retinal Research CenterManhattan Eye, Ear and Throat HospitalNew YorkUSA
  3. 3.Rabin Medical CenterDepartment of OphthalmologyPetach-TikvaIsrael
  4. 4.Department of OphthalmologyNew York UniversityNew YorkUSA
  5. 5.Unit of Macula, Oftalvist ClinicValenciaSpain

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