Signs and symptoms: Asteroid hyalosis is a primarily unilateral disorder that typically occurs in patients over 60 and in men twice as often as women. Usually asymptomatic, in severe cases asteroid hyalosis can mildly affect visually acuity. Complaints of floaters are a rarity.
Ophthalmoscopically, asteroid hyalosis appears as multiple, discrete, refractile yellow or yellow-white particles suspended in the vitreous. In early stages, there are fewer bodies and they accumulate in the inferior vitreous. Advanced cases can be so dense as to impair your view of the posterior fundus. In whites the prevalence of asteroid hyalosis is 1-2%, and it is bilateral in about 10% of cases.1 This prevalence seems to increase with age.
Pathophysiology: Asteroid bodies represent small calcium-laden lipids suspended within and attached to the hyaluronic acid framework of the vitreous body. While we understand the composition of the asteroid bodies, the exact genesis remains unclear. Current theories suggest that asteroid hyalosis results from aging collagen within the vitreous or a depolymerization of hyaluronic acid.
Management: Asteroid hyalosis is a benign condition in itself. Although it progresses, it never leads to severe vision loss, and the mild symptoms occur rarely. The vast majority of cases merely require documentation. More often than not, this disorder poses a greater challenge to the examining physician because it can obscure details of the underlying retina. Consider treatment only in patients who are also being managed for retinal disease (proliferative diabetic retinopathy, retinal tear or detachment). Vitrectomy is typically indicated in these instances.
1. Moss SE, Klein R, Klein BE. Asteroid hyalosis in a population: the Beaver Dam eye study. Am J Ophthalmol 2001 Jul;132(1):70-5.
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& Eyelashes | Conjunctiva
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Uvea | Vitreous & Retina | Optic Nerve & Brain | Oculosystemic Disease
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