On an OCT scan, you observe pigment in the vitreous floating above the retina. Which pigment is this most consistent with?

On an OCT scan, you observe pigment in the vitreous floating above the retina. Which pigment is this most consistent with?

• A. Pigment dispersion syndrome
• B. Asteroid hyalosis
• C. Macular traction
• D. Vitreous hemorrhage

Answer: (B)

The seeing is most consistent with asteroid hyalosis. On OCT, asteroid hyalosis shows numerous small, bright, refractile particles in the vitreous cortex that float anterior to the retina. These particles are calcium phosphate soap deposits, and they move with eye movements but stay in the vitreous rather than involving the retina or posterior segment structures. They typically cause only minimal visual disturbance and don’t create retinal traction or edema. Pigment dispersion syndrome involves pigment release from the iris; it primarily affects the anterior segment and would not present as floating vitreous particles. Macular traction is a retinal problem where the retina itself is distorted by vitreoretinal adhesion, seen as changes at the macula, not discrete vitreous specks. A vitreous hemorrhage would present with blood in the vitreous, often hazy, may layer with gravity, and would not appear as tiny, mobile, refractile specks. Therefore, the pattern described aligns best with asteroid hyalosis.

The seeing is most consistent with asteroid hyalosis. On OCT, asteroid hyalosis shows numerous small, bright, refractile particles in the vitreous cortex that float anterior to the retina. These particles are calcium phosphate soap deposits, and they move with eye movements but stay in the vitreous rather than involving the retina or posterior segment structures. They typically cause only minimal visual disturbance and don’t create retinal traction or edema.

Pigment dispersion syndrome involves pigment release from the iris; it primarily affects the anterior segment and would not present as floating vitreous particles. Macular traction is a retinal problem where the retina itself is distorted by vitreoretinal adhesion, seen as changes at the macula, not discrete vitreous specks. A vitreous hemorrhage would present with blood in the vitreous, often hazy, may layer with gravity, and would not appear as tiny, mobile, refractile specks. Therefore, the pattern described aligns best with asteroid hyalosis.