https://pubmed.ncbi.nlm.nih.gov/24296397/

Sebag, J., Yee, K.M., Wa, C.A., Huang, L.C. and Sadun, A.A., 2014. Vitrectomy for floaters: prospective efficacy analyses and retrospective safety profile. Retina, 34(6), pp.1062-1068.

Is it possible to improve vision in patients suffering from floaters? This study investigates this question by measuring contrast sensitivity function in individuals with floaters. In the short-term, vitrectomy improved contrast sensitivity function. This documents the effectiveness and safety of the procedure, but larger and longer studies are need.

https://doi.org/10.1167/iovs.14-15414

Mamou, J., Wa, C.A., Yee, K.M., Silverman, R.H., Ketterling, J.A., Sadun, A.A. and Sebag, J., 2015. Ultrasound-based quantification of vitreous floaters correlates with contrast sensitivity and quality of life. Investigative ophthalmology & visual science, 56(3), pp.1611-1617.

Is it possible to quantify vitreous opacities and measure the impact of floaters on vision? This study investigates this question by using ultrasound to measure the density of vitreous and evaluate vision by measuring the contrast sensitivity function. This study found that increasing vitreous density is associated with reduced contrast sensitivity function, offering a means to quantify the impact of floaters on vision. This approach is not only useful in quantifying the impact of the disease on an individual patient’s vision and quality of life, but can also be used to assess potential improvements following treatments of various types.

https://www.ajo.com/article/S0002-9394(16)30442-1/fulltext

Garcia, G.A., Khoshnevis, M., Yee, K.M., Nguyen-Cuu, J., Nguyen, J.H. and Sebag, J., 2016. Degradation of contrast sensitivity function following posterior vitreous detachment. American journal of ophthalmology, 172, pp.7-12.

Does posterior vitreous detachment (PVD) reduce vision, specifically the ability to discern shades of gray (contrast sensitivity function; CSF)? Can this be normalized by limited vitrectomy? This study documents that individuals without floaters can develop them after experiencing PVD, which can result in substantial reduction of CSF. Limited vitrectomy cured the floaters in each case and restored CSF to normal levels. This supports prior studies which suggest that the CSF not only offers a measure of floater severity in the clinical setting, but also the very favorable response to surgery. The limitation in this study is the small number of subjects.

https://doi.org/10.1155/2017/5496298

Lin, Z., Zhang, R., Liang, Q.H., Lin, K., Xiao, Y.S., Moonasar, N. and Wu, R.H., 2017. Surgical outcomes of 27-gauge pars Plana vitrectomy for symptomatic vitreous floaters. Journal of ophthalmology, 2017.

Explores outcomes from 27-gauge pars plana vitrectomy for symptomatic floaters in 47 patients with a mean age of 34.7 years. Patient satisfaction was high (91.5%), although not evaluated with a standardized/validated questionnaire. 91.3% of patients felt their floaters were removed completely or only had an acceptable residual. No operative complications occurred. However, there was one case of endophthalmitis and one retinal detachment. Although the procedure was generally effective and safe, there are risks of severe complications, which suggest the procedure should be undertaken with caution.

https://jamanetwork.com/journals/jamaophthalmology/article-abstract/2643488

Shah, C.P. and Heier, J.S., 2017. YAG laser vitreolysis vs sham YAG vitreolysis for symptomatic vitreous floaters: a randomized clinical trial. JAMA ophthalmology, 135(9), pp.918-923.

This study suggests that Nd:YAG laser can offer effective and safe treatment for individuals deemed to be suitable candidates based on the size and location of the opacities. However, there are methodological problems with the study [https://doi.org/10.1001/jamaophthalmol.2018.0212] and the results showed improvement in only half of treated subjects. Thus, better studies using objective outcome measure are needed.

https://doi:10.1007/s00417-018-3957-1

Garcia, G.A., Khoshnevis, M., Yee, K.M., Nguyen, J.H., Nguyen-Cuu, J., Sadun, A.A. and Sebag, J., 2018. The effects of aging vitreous on contrast sensitivity function. Graefe’s Archive for Clinical and Experimental Ophthalmology, 256(5), pp.919-925.

Is contrast sensitivity function (CSF) impacted by aging changes in the vitreous body? This study suggests that posterior vitreous detachment (PVD), which is the leading cause of the visual phenomenon of floaters, causes substantial degradation of CSF. Furthermore, after PVD there are changes in the vitreous body that further increase vitreous density, as measured by ultrasound. Concurrently, CSF continues to worsen.

https://www.sciencedirect.com/science/article/abs/pii/S2468653018301313?via%3Dihub

Sebag, J., Yee, K.M., Nguyen, J.H. and Nguyen-Cuu, J., 2018. Long-term safety and efficacy of limited vitrectomy for vision degrading myodesopsia resulting from vitreous floaters. Ophthalmology Retina, 2(9), pp.881-887.

What are the long-term effects of surgery for floaters? Limited vitrectomy to remove the vitreous opacities that cause the visual phenomenon of floaters was found to be successful in improving vision (contrast sensitivity normalized within 1 week of surgery in each of 139 consecutive cases) and patient well-being (standardized/validated NEI Visual Function Questionnaire). There were no cases of infection, retinal tears and retinal detachments occurred in only 1.5% of cases, and cataracts developed in 16.9% of cases. Thus, this long-term study found that limited vitrectomy is an effective and safe treatment for floaters with minimal complications.

https://doi:10.1016/j.ajo.2019.02.032

Rostami, B., Nguyen-Cuu, J., Brown, G., Brown, M., Sadun, A.A. and Sebag, J., 2019. Cost-effectiveness of limited vitrectomy for vision-degrading myodesopsia. American journal of ophthalmology, 204, pp.1-6.

What is the cost effectiveness of limited vitrectomy in improving quality of life for floater patients? Based on results using the National Eye Institute Visual Function Questionnaire and measures of contrast sensitivity function before and after surgery, limited vitrectomy is more cost effective in improving quality of life than cataract surgery, amblyopia (i.e., lazy eye) therapy, or retinal detachment surgery.

https://pubs.acs.org/doi/10.1021/acsnano.9b04050

Sauvage, F., Fraire, J.C., Remaut, K., Sebag, J., et al.., 2019. Photoablation of human vitreous opacities by light-induced vapor nanobubbles. ACS nano, 13(7), pp.8401-8416.

This laboratory study explores the use of gold nanoparticles and low-energy lasers for destruction of vitreous opacities. This method requires ~1,000 times less energy than current methods employing YAG laser, theoretically enabling safer, faster, and more reliable cures than current laser-based methods. Although far more research and development are needed, this study suggests that this new method has the potential to be further developed as a treatment option, if experiments in animals (which have been completed) followed by human trials are successful.

https://www.aaojournal.org/article/S0161-6420(18)32553-3/fulltext

Nguyen, J.H., Nguyen-Cuu, J., Yu, F., Yee, K.M., Mamou, J., Silverman, R.H., Ketterling, J. and Sebag, J., 2019. Assessment of Vitreous Structure and Visual Function after Neodymium: Yttrium–Aluminum–Garnet Laser Vitreolysis. Ophthalmology, 126(11), pp.1517-1526.

Does YAG laser treatment benefit patients with floaters? This study explores how patients who have had YAG laser treatment of vitreous opacities compared to untreated patients complaining of floaters. Analyses found no differences in the YAG-treated patients compared to untreated patients. However, in a small subgroup of patients there was decreased vitreous density and better contrast sensitivity function, suggesting that there may be some patients who benefit from YAG laser treatment.  Prospective, randomized trials are needed to determine this and to identify what type of patients might benefit.

https://doi.org/10.1155/2019/8956952 

Sun, X., Tian, J., Wang, J., Zhang, J., Wang, Y. and Yuan, G., 2019. Nd: YAG laser vitreolysis for symptomatic vitreous floaters: application of infrared fundus photography in assessing the treatment efficacy. Journal of ophthalmology, 2019.

This study suggests that Nd:YAG laser can offer effective and safe treatment for individuals deemed to be suitable candidates based on the size and location of the opacities. However, the methods employed in this study are not standardized and validated, and the journal that published this paper has a relatively low status in the eye world.

https://www.sciencedirect.com/science/article/abs/pii/S2468653019306086

Hwang, E.S., Kraker, J.A., Griffin, K.J., Sebag, J., Weinberg, D.V. and Kim, J.E., 2020. Accuracy of spectral-domain OCT of the macula for detection of complete posterior vitreous detachment. Ophthalmology Retina, 4(2), pp.148-153.

Can optical coherence tomography (OCT) imaging accurately diagnose posterior vitreous detachment (PVD)? This study suggests that when compared to discovery during surgery (considered the ‘gold standard’) spectral-domain OCT cannot accurately diagnose PVD (predictive value = 53%). The investigators suggested that diagnostic accuracy may be improved by employing ultrasound.

https://doi.org/10.1038/s41433-020-0825-0 

Zeydanli, E.O., Parolini, B., Ozdek, S., Bopp, S., Adelman, R.A., Kuhn, F., Gini, G., Sallam, A.B. and Aksakal, N., 2020. Management of vitreous floaters: an international survey the European Vitreo-Retinal Society Floaters study report. Eye, 34(5), pp.825-834.

Retrospective survey study that suggests that pars plana vitrectomy for symptomatic floaters generally resulted in high patient satisfaction with relatively low rates of severe complications in a large group of patients (581 eyes operated on by 48 surgeons in 16 countries). The authors concluded that surgery may be safer with core vitrectomy, no surgical PVD induction, and moderately high cut rates (>1500 cuts/min). Proper patient selection and informed consent are important considerations as to whether or not to perform the procedure.

https://doi.org/10.1016/j.ajo.2020.09.017

Nguyen, J.H., Nguyen-Cuu, J., Mamou, J., Routledge, B., Yee, K.M. and Sebag, J., 2021. Vitreous structure and visual function in myopic vitreopathy causing vision-degrading myodesopsia. American Journal of Ophthalmology, 224, pp.246-253.

Is myopia (near-sightedness) in patients complaining of floaters associated with changes in vitreous and vision? This study links structural abnormalities that are common in myopic eyes with the presence of increased vitreous density and reduced contrast sensitivity function (CSF). It offers an explanation as to why myopia is associated with the development of Vision Degrading Myodesopsia (VDM ≡ clinically significant floaters) in young people. The worse the axial myopia, the more dense was the vitreous body and the more degraded was CSF.

https://iovs.arvojournals.org/article.aspx?articleid=2772521

Ruminski, D., Sebag, J., Toledo, R.D., Jiménez-Villar, A., Nowak, J.K., Manzanera, S., Artal, P. and Grulkowski, I., 2021. volumetric optical imaging and quantitative analysis of age-related changes in anterior human vitreous. Investigative Ophthalmology & Visual Science, 62(4), pp.31-31.

This study explores the use of 3-D swept source optical coherence tomography (SS-OCT) for imaging the vitreous body in relation to assessing age-related changes. While imaging the entire vitreous body was the goal, only the anterior portion (the part of the vitreous in the front of the eye, nearer to the lens than the retina) could be evaluated. Nonetheless, this method offers a detailed means to image vitreous opacities that cause the visual phenomenon of floaters, and work is ongoing to images the entire vitreous body.

https://pubs.rsc.org/en/content/articlehtml/2021/nh/d1nh00157d

Barras, A., Sauvage, F., de Hoon, I., Braeckmans, K., Hua, D., Buvat, G., Fraire, J.C., Lethien, C., Sebag, J., Harrington, M. and Abderrahmani, A., 2021. Carbon quantum dots as a dual platform for the inhibition and light-based destruction of collagen fibers: implications for the treatment of eye floaters. Nanoscale Horizons.

Using carbon quantum dots (CQDs), a kind of nanoparticle, in combination with a low energy laser that distributes ~1,000 times less energy than the currently used YAG lasers, vitreous opacities resulting from collagen aggregation can be efficiently destroyed. In combination with other nanoparticle research, this study highlights the need to further explore these technologies in order to develop a safe, effective treatment of Vision Degrading Myodesopsia (VDM). Positive in vitro results were obtained for destroying opacities in vitreous material removed from floater patients undergoing vitrectomy.

https://iovs.arvojournals.org/article.aspx?articleid=2776180 

Sauvage, F., Nguyen, V.P., Sebag, J., Fraire, J., Remaut, K., Braeckmans, K., Paulus, Y.M. and De Smedt, S., 2021. Gold nanoparticles for the treatment of eye floaters by light-induced vapor nanobubbles. Investigative Ophthalmology & Visual Science, 62(8), pp.3307-3307.

Investigates the use of gold nanoparticles and low energy, pulse-based lasers for photoablation of opacities. The nanoparticles effectively bound to Type I collagen fibers stimulated outside of the eye. They also bound effectively to collagen fibers injected into the vitreous of rabbits. In both cases, opacities were effectively and rapidly destroyed following the use of low energy, pulsed-lasers. This study shows promise and supports further investigation of the method via human trials.

https://doi.org/10.1080/08820538.2021.1887898

Kalavar, M., Hubschman, S., Hudson, J., Kuriyan, A.E. and Sridhar, J., 2021, February. Evaluation of available online information regarding treatment for vitreous floaters. In Seminars in Ophthalmology (Vol. 36, No. 1-2, pp. 58-63). Taylor & Francis.

Assessment of the quality, content, and readability of online information relating to vitreous floaters. Generally, the quality of information varies.

https://doi.org/10.1080/09500340.2021.1948624

Karitans, V., Fomins, S. and Ozolinsh, M., 2021. Phase retrieval for studying the structure of vitreous floaters simulated in a model eye. Journal of Modern Optics, 68(15), pp.792-797.

This explores the use of software to track floaters, technology that could be useful in implementing real-time correction of the visual phenomenon that relies on reducing or canceling the resulting retinal shadowing using a phase retrieval method. The computational load is currently limiting.