Emmetropization, visual acuity, and strabismus outcomes among hyperopic infants followed with partial hyperopic corrections given in accordance with dynamic retinoscopy.

OBJECT: To record emmetropization, visual acuity, and strabismus outcomes among hyperopic infants followed with partial hyperopic corrections given in accordance with dynamic retinoscopy (DR). METHODS: Infants (3.5-12 months of age) with ≥5 D hyperopia were followed without glasses or partial hyperopic corrections prescribed according to their near dynamic accommodative abilities determined by DR responses at the initial visit and follow-ups. Refraction and binocular accommodative ability assessments were made at 3-month intervals up to the age of 1 and at 6-month intervals afterwards for a mean 35.4±2.1 months; main outcome measures being the development of esotropia, emmetropization rate, and visual acuity level after emmetropization period. RESULTS: Among 211, 146 were normal accommodators initially (Group 1). These infants were followed without treatment and none presented with strabismus. Sixty-five infants were hypo-accommodators (Group 2) and received minimum DR-based corrections. Of the 65 infants 31 (48%) developed strabismus (Group 2B). The remaining 34 constituted Group 2A. Each of the three groups showed an overall reduction of hyperopia by 0.37±0.25 days per year, 0.50±0.28 days per year, and 0.60±0.20 days per year, respectively. Visual acuity assessments among Groups 1 and 2A revealed normal values (0.2-0.0 LogMAR); among Group 2B 19% were within normal range. CONCLUSIONS: Binocular accommodative behavior at the initial visit seems to be one of the indicators for pointing out infants at risk of developing strabismus and amblyopia. Prescription of DR-based corrections to hyperopic orthotropic infants does not impede emmetropization and result in normal visual acuities after emmetropization period.

Bond strength of self-etch adhesives after saliva contamination at different application steps.

This study evaluated and compared the effect of saliva contamination and possible decontamination methods on bond strengths of two self-etching adhesive systems (Clearfil SE Bond [CSE], Optibond Solo Plus SE [OSE]). Flat occlusal dentin surfaces were created on 180 extracted human molar teeth. The two bonding systems and corresponding composite resins (Clearfil AP-X, Kerr Point 4) were bonded to the dentin under six surface conditions (n=15/group): group 1 (control): primer/bonding/composite; group 2: saliva/drying/primer/bonding/composite; group 3: primer/saliva/rinsing/drying/primer/bonding/composite; group 4: primer/saliva/rinsing/drying/bonding/composite; group 5: primer/bonding (cured)/saliva/rinsing/drying/primer/bonding/composite; group 6: primer/bonding (cured)/saliva/removing contaminated layer with a bur/rinsing/drying/primer/bonding/composite. Shear bond strength was tested after specimens were stored in distilled water at 37°C for 24 hours. One-way analysis of variance and Tukey post hoc tests were used for statistical analyses. For CSE, groups 2, 3, and 4 and for OSE, groups 6, 2, and 4 showed significantly lower bond strengths than the control group (p<0.05). CSE groups 5 and 6 and OSE groups 3 and 5 revealed bond strengths similar to the control. When saliva contamination occurred after light polymerization of the bonding agent, repeating the bonding procedure recovered the bonding capacity of both self-etch adhesives. However, saliva contamination before or after primer application negatively affected their bond strength.

A five-year clinical evaluation of direct nanofilled and indirect composite resin restorations in posterior teeth.

AIM: To assess the clinical efficacy of posterior composite resin restorations placed directly and indirectly in posterior teeth after five years. MATERIALS AND METHODS: A total of 108 cavities in 54 patients were restored with three direct composite resins (Filtek SupremeXT [FSXT], Tetric Evo Ceram [TEC], AELITE Aesthetic [AA]) and two indirect composite resins (Estenia [E] and Tescera ATL [TATL]). All restorations were evaluated by two examiners using the United States Public Health Service criteria at baseline and five years after placement. Statistical analysis was completed with Fisher exact and McNemar χ(2) tests. RESULTS: At baseline, 4% (five) of the restored teeth presented postoperative sensitivity; however, only one of them (a member of the E group) required canal treatment and replacement after two years. At the five-year evaluation, all restorations were retained, with Alpha ratings at 100%. Only one tooth (in the TEC group) required replacement after three years due to secondary caries. Color match, surface texture, and marginal integrity were predominantly scored as Alpha after five years for all groups. After that time, marginal discoloration was scored as Alpha in 64% of AE restorations, 70% of TATL restorations, 73% of E restorations, and 87% of FSXT restorations. There were no Charlie scores recorded for any of the restorative systems. CONCLUSIONS: Under controlled clinical conditions, indirect composite resin inlays and direct composite resin restorations exhibited an annual failure rate of 2.5% and 1.6%, respectively, after five years. Therefore, the investigated materials showed acceptable clinical performance, and no significant differences were found among them.

Effect of Er,Cr:YSGG laser on the microtensile bond strength of two different adhesives to the sound and caries-affected dentin.

OBJECTIVE: This study examined the effect of Er,Cr:YSGG laser irradiation on the microtensile bond strength (microTBS) of a three-step etch-and-rinse and a two-step self-etch adhesive to sound and caries-affected dentin. METHODS: Sixteen freshly extracted human molars with occlusal dentin caries were used. The caries lesion was removed by one of the following methods: conventional treatment with burs or Er,Cr:YSGG laser (Waterlase MD, Biolase). The adhesive systems (AdheSE, Ivoclar Vivadent and Scotchbond Multi Purpose, 3M ESPE) were applied to the entire tooth surface according to the manufacturers' instructions. Resin composites were applied to the adhesive-treated dentin surfaces and light-cured. Each tooth was sectioned into multiple beams with the "non-trimming" version of the microtensile test. The specimens were subjected to microtensile forces (BISCO Microtensile Tester, BISCO). The data was analyzed by three-way ANOVA and independent t-tests (p=0.05). RESULTS: Er,Cr:YSGG laser irradiation exhibited similar microTBS values compared to that of conventional bur treatment, regardless of the adhesive system and type of treated dentin. The self-etch system revealed lower microTBS values, both with conventional and laser treatment techniques, compared to the etch-and-rinse adhesive in sound and caries-affected dentin (p<0.05). CONCLUSION: Er,Cr:YSGG laser irradiation did not negatively affect the bonding performance of adhesive systems to sound and caries-affected dentin.

Macular involvement in secondary systemic amyloidosis.

PURPOSE: A patient with subretinal and preretinal hemorrhage after secondary systemic amyloidosis due to familial Mediterranean fever is presented. METHODS: Case presentation. RESULTS: A 30-year-old woman with secondary systemic amyloidosis secondary to familial Mediterranean fever presented with painless visual loss in the right eye. The examination demonstrated multiple subretinal and preretinal hemorrhages, massive deposits which may represent amyloid material at the left macular region. After 6 months, the hemorrhages disappeared, but deposits persisted. CONCLUSIONS: The macular deposition and hemorrhage is an uncommon manifestation of secondary systemic amyloidosis secondary to familial Mediterranean fever. Further evidence is necessary to understand the nature of these deposits and their relevance to secondary systemic amyloidosis and/or familial Mediterranean fever.

A case of retinal detachment in retinitis pigmentosa.

PURPOSE: To report case of retinitis pigmentosa in association with rhegmatogenous retinal detachment. METHODS: An eight year old boy complained of a sudden visual loss. The patient had night blindness, bone spicule-like hyperpigmentation, pale optic disc in both eyes, and the retina was totally detached in the right eye. RESULTS: He was initially treated with conventional scleral buckling surgery, then pars plana vitrectomy with silicone tamponade was performed and retinal reattachment was established. After the phacoemulsification combined with silicone oil removal the final visual acuity of counting fingers was obtained. CONCLUSIONS: The association of retinitis pigmentosa and rhegmatogenous retinal detachment is uncommon in young patients.

Antibacterial activities of MDPB and fluoride in dentin bonding agents.

The aim of this study was to compare in vitro antibacterial activity of MDPB containing bonding system ABF with activities of three Fluoride containing bonding systems (Fuji Bond LC (FBLC), Prime&Bond NT (PBNT), and FluoroBond (FLB). Two bacterial strains were tested: Streptococcus mutans and Lactobacillus acidophilus. The study was performed on Muller Hinton Agar by Agar Well Technique. The bacterial agar was evenly distributed over the surface of petri dishes. Standard wells were punched into the agar. The test materials were placed in the wells of Muller Hinton agar plates, inoculated with Streptococcus mutans NCTC10449 and Lactobacillus acidophilus. The diameters of inhibition zones produced around the materials were measured after 24 h of incubation at 37 +/- 1 degrees C. For statistical analysis, Duncan's multiple range test was used. The primers of bonding agents were highly effective against to Streptococcus mutans. The MDPB containing primer of ABF Bond produced the greatest inhibition zones against to Lactobacillus acidophilus. It was followed by FLB primer. Lactobacillus acidophilus was resistant to FBLC primer and bonding, ABF, PBNT and FLB bonding agents. The results of this study indicated that, incorporation of MDPB in primer of self-etch system increased its antibacterial activity especially against to Lactobacillus acidophilus. However, all bonding systems except for bonding agent of ABF showed some antibacterial activity against to Streptococcus mutans.

Effect of home bleaching agents on the microhardness of human enamel and dentin.

In this study, the effects of home bleaching agents that contains carbamide peroxide (in different concentrations such as 10 and 15%) on the surface hardness of human enamel and dentine were evaluated. The buccal surfaces of 90 recently extracted human mandibular anterior teeth were used. The specimens in the dentine group were ground to expose of dentine surface. Then, samples in both enamel and dentine group were randomly divided into six main groups with 15 in each group. In the group 1 and 4, 15% carbamide peroxide was applied to the enamel and dentine surfaces and then the teeth were left in an incubator at 37 degrees C and 100% humidity for 4 h first, then left 28 h after repeating the same procedures seven times. The teeth were treated with 10% carbamide peroxide in groups 2 and 5 and distilled water in groups 3 and 6 (control groups), using the same procedures. Vicker's microhardness of enamel and dentine were assessed on each tooth before and after each treatment period (4 and 28 h). The hardness of control group specimens was also obtained after 4 h in distilled water and then after 28 h. For statistical analysis one-way ANOVA and post-hoc Tukey tests were used. For both 10 and 15%, there were no statistically significant differences between the untreated control specimens and the specimens treated with the bleaching materials for enamel and dentine at any given measurement time (P > 0.05). Nevertheless, in vivo use of bleaching agents on tooth hard tissues requires further analysis.

Influence of dentinal regions on bond strengths of different adhesive systems.

This in vitro study assessed comparatively the shear bond strengths of three composite resins, 3M Valux Plus (3MVP), Herculite (H), Clearfil AP-X (CAP-X), a polyacid modified composite resin Dyract (D), and a resin modified glass-ionomer materials Vitremer (V), to cervical and buccal dentine regions of extracted human molar teeth. Four different bonding systems, 3M ScotchBond Multipurpose (SB), Clearfil Liner Bond 2 (LB2), Opti Bond (OB), and Prime & Bond 2.1 (PB 2.1) were used with the manufacturer's respective composite and compomer materials. One hundred freshly extracted mandibular molar teeth were selected for this study. Flat buccal dentine surfaces were created on 50 teeth and cylindrical rods of the five materials were bonded to the dentine surfaces. For assessment of cervical bond strengths, the materials were bonded to mesial and distal enamel bordered occlusal dentinal surfaces of the remaining 50 teeth. The five groups of restorative procedures were applied as follows; Group 1: SB + 3MVP, Group 2: LB2 + CAP-X, Group 3: OB + H, Group 4: PB2.1 + D, Group 5: Vitremer primer (VP) VP + V. Each restorative procedure thus had 20 specimens (10 buccal + 10 cervical). After 24 h of water storage (37 degrees C), the specimens were tested on a Universal Testing machine in shear with a cross head speed of 0.5 mm min-1. The bond strength values were calculated in MPa and the results were evaluated statistically using Kruskal-Wallis one-way/anova and Mann-Whitney U-tests. It was found that the bond strengths of SB + 3MVP, LB2 + CAP-X and VP + V to buccal dentine surfaces were significantly stronger (P < 0.05) than those to the occluso-cervical dentine floors. When the bond strengths to the occluso-cervical dentine and buccal dentine surface were compared, there was no significant difference between the materials (P > 0.05). Vitremer was found the least successful adhesive material in terms of shear bond strength on both buccal and occluso-cervical dentine surfaces.

The management of giant retinal tears with silicone oil.

PURPOSE: To report the surgical success of vitrectomy with silicone oil tamponade in the treatment of retinal detachment associated with giant retinal tears due to various factors. METHODS: We retrospectively evaluated 21 eyes of 21 patients with retinal tears 90 degrees or greater that underwent vitrectomy, with injection of perfluorocarbon liquids and silicone oil tamponade. Eight eyes (38.1%) had previous ocular surgery (4 aphakia-pseudophakia, 4 pars plana vitrectomy), 4 eyes (19.0%) had a history of trauma (blunt injuries in 2 and penetrating injury in 2), 3 (14.3%) had high myopia. Six eyes (28.6%) had no known condition predisposing to development of giant retinal tear. RESULTS: Retinal attachment was obtained in 17 (80.5%) of 21 eyes, with a mean follow-up of 12.5 months. Visual acuity improved in 15 eyes (71.4%). CONCLUSIONS: Pars plana vitrectomy with silicone oil tamponade proved highly effective in giant retinal tears in terms of anatomical and functional results.

Comparison of antibacterial activity of two dentin bonding systems using agar well technique and tooth cavity model.

OBJECTIVE: This study compared the antibacterial activities of two dentin bonding systems (ABF, Kuraray and Reactmer Bond, Shofu) by a conventional agar well technique and a newly designed in vitro test using tooth model. METHODS: In the agar well technique, the test materials were filled in the wells of Muller Hinton agar plates inoculated with Streptococcus mutans NCTC10449, and the diameters of inhibition zones produced around the materials were measured after 24h of incubation. For the tooth model test, three cavities (diameter 1mm, depth 2mm) were prepared in the flat occlusal dentin of human extracted molar. After sterilization, the teeth were left in broth culture of 1.56 x 10(8)CFU/ml of S. mutans at 37 degrees C for 72h for allowing bacteria to invade the cavity. The dentin bonding systems were applied separately to each of the two infected cavities, and the third cavity was left unapplied for control. After sealing the occlusal surfaces, the teeth were kept in physiologic saline solution at 37 degrees C for 72h. The standardized amounts of dentin chips (120+/-5mg) were obtained from the cavity walls and the number of bacteria recovered was determined. The results were analyzed by One Way ANOVA, Kruskal Wallis and Mann-Whitney's U tests. RESULTS: The primer of ABF and Reactmer Bond produced inhibition zones with similar sizes (p>0.05), but the bonding resin of ABF did not produce any inhibition. When tested by the model cavity method, the application of ABF resulted in significantly less bacterial recovery than Reactmer Bond (p<0.05), demonstrating substantial antibacterial effects. CONCLUSIONS: The tooth model method used in this study was effective for evaluating the substantial antibacterial effects of dentin bonding agents, and the experimental dentin bonding system ABF was demonstrated to be able to inactivate the bacteria in the cavity effectively in comparison with little antibacterial activity shown by Reactmer Bond.

Shear bond strengths of tooth fragments reattached or restored.

This study investigated the shear bond strengths of sectioned human mandibular incisor edge fragments reattached using luting cements, bonding agents or restored with composite resins. Seventy teeth were randomly distributed among six experimental groups and a control group. Leaving half of the anatomic crowns exposed, the teeth were embedded in self-cure acrylic resins with the exposed part then sectioned. The fragments in groups 1-4 were bonded to their respective teeth using Clearfil Liner Bond 2V, Scotch Bond Multi Purpose Plus, Panavia-F and 3M Opal Luting cement. The 5th and 6th groups were restored with composite resins (Silux 3M and Clearfil AP-X) using their bonding agents (Single Bond and Clearfil SE Bond). The results indicated that reattachment of fractured incisal fragments by using new generation bonding agents was effective against shear stresses, comparable with the intact teeth. Instead of restoration with composite resins therefore reattachment of a fractured fragment might be more preferable in cases of dental trauma.

Bond strength of five current adhesives to caries-affected dentin.

Five current dentin adhesives were evaluated for their ability to bond to caries-affected dentin. The materials were: total etch [Solid Bond (SB)], two self-etch [Clearfil SE Bond (CSE), Etch and Prime (EP)], two one bottle [Prime and Bond 2.1 (PB), One Coat Bond (OCB)]. Sixty extracted molar teeth with proximal caries (mesial or distal) extending into mid-dentin were used. By grinding normal and caries-affected proximal surfaces, flat dentin surfaces were obtained. The surfaces were then bonded with each adhesive system and composite resins were added to the surfaces by packing the material into a cylindrical-shaped plastic matrix with an internal diameter of 2.5 mm and height of 3 mm. Shear bond testing was performed following 10 days incubation of specimens in distilled water at 37 degrees C. Results were analysed by Kruskal-Wallis ANOVA, and Mann-Whitney U multiple comparison test and Wilcoxon rank tests. The results obtained with CSE, SB, and EP were similar in caries affected and normal dentin (P > 0.05). But bonds made to normal dentin with OCB and PB were lower (P < 0.05) than bonds to caries-affected dentin. Bonding to caries-affected dentin with CSE (24.49 +/- 5.38), SB (21.49 +/- 9.15), and EP (21.19 +/- 9.17) showed shear bond strengths higher than OCB (17.43 +/- 9.78) and PB (14.10 +/- 7.94) (P < 0.05). Bonding to normal dentin with CSE (29.91 +/- 8.95) was the highest (P < 0.05). SB (21.17 +/- 5.41) and EP (17.45 +/- 6.21) showed shear bond strengths higher than OCB (11.99 +/- 10.15) and PB (10.57 +/- 4.56) (P < 0.05).

Surgical management of retinal detachment with choroidal coloboma.

PURPOSE: To verify the functional and anatomical results of retinal detachments related to choroidal coloboma. METHODS: Seven eyes with retinal detachment secondary to retinal breaks at the margin of or within a choroidal coloboma were analysed retrospectively. RESULTS: Scleral buckling was performed in five of the seven eyes; two needed additional pars plana vitrectomy (PPV) with internal tamponade using silicone oil to reattach the retina. In two eyes PPV with internal tamponade using silicone oil or gas was used as a primary procedure. All seven eyes were reattached. Five eyes (71.4%) showed improvement or had visual acuity of 20/400 or better after surgery, but two remained unchanged. CONCLUSIONS: Retinal detachment secondary to choroidal coloboma can be treated successfully by scleral buckling or PPV with internal tamponade.

Amalgam repair: evaluation of bond strength and microleakage.

This study evaluated the tensile bond strength of "repaired" amalgams and compared the degree of microleakage. Amalgam (Cavex avalloy) was condensed into plastic tubes (3 mm in diameter, 10 mm in height) to the half-length. After storage in water at 37 degrees C for two days, the remaining parts of tubes were filled with amalgam (A), cavity varnish (CV)+A, Liner Bond 2V (LB2V)+A, 3M Opal Luting Cement (3MOLC)+A, Panavia F(PF)+A, Metabond(MB)+A, Fuji BondLC(FB)+A, HytacOSB(HOSB)+Hytac Aplitip (H), Liner Bond2V+Clearfil AP-X(CAP). The bond strengths for 15 samples of each restoration group were determined. For the microleakage study, MOD cavities of 90 extracted human premolars were used. The distal half of cavities were filled with amalgam. After storage in water at 37 degrees C for two days, the mesial half of the cavities were filled to simulate a clinical repair. The "repair" was placed using the procedures applied in the bond strength study. The teeth were stained with basic fuchsine (0.5%), sectioned and evaluated for dye penetration. In both parts of study, the data were analyzed by ANOVA and Duncan's multiple range tests. Bond strength values (MPa) were: A+PF+A 3.84+/-1.08, A+LB2V+A 3.15+/-0.97, A+LB2V+CAP 3.05+/-0.53, A+MB+A 2.86+/-0.88, A+HOSB+H 2.58+/-0.51, A+3MOLC+A 2.11+/-0.75, A+FB+A 0.68+/-0.59. The repaired A+A and A+CV+A groups were separated before testing. The A+PF+A group showed the highest bond strength (p<0.05). Microleakage in the cervical margins of repaired restorations was lower in the amalgam groups than microleakage in the resin composite and compomer groups. PF, MB, 3MOLC and FB performed better at the amalgam "repair" interface. The A+LB2V+A group showed no microleakage at both the occlusal and gingival test regions.

Bonding strength to two different surfaces of dentin under simulated pulpal pressure.

PURPOSE: The purpose of this in vitro study was to measure and compare the in vitro shear bond strengths (SBS) of the following dentin bonding systems to different dentin surfaces under simulated pulpal pressure: Liner Bond 2 (self-etching) (LB2), Liner Bond 2V (self-etching) (LB2V), Opti Bond Solo (single component) (OBS), Fuji Bond LC (filled) (FBLC), Prime & Bond 2-1 (single component) (P&B2-1), and Solid Bond (total etching) (SB). MATERIALS AND METHODS: Occlusal and buccal surfaces of 60 extracted human molars were prepared to expose the dentin bonding surface. After being wet ground with 600-grit abrasive papers, teeth were randomly assigned to 6 equal groups of 10 each. The dentin surfaces were treated with the bonding systems mentioned above, and resin composite cylinders (Clearfil AP-X) were built up under simulated pulpal pressure when diluted bovine serum was used as the pulpal fluid. After one day of storage in 37 degrees C water, the specimens were shear tested to failure on an Instron machine. RESULTS: The data were statistically analyzed with the Student's t-test and a post hoc Tukey test. Comparing buccal surfaces, the post hoc Tukey test indicated no significant differences among all the test groups (p > 0.05). On occlusal surfaces, the post hoc Tukey test indicated significant differences among the tested groups (p < 0.05). The Student's t test revealed significant differences between the occlusal and buccal shear bond strength values in LB 2, LB2V, and SB groups (p < 0.05). CONCLUSION: The strength of adhesion to dentin depends upon both the adhesive system used - with self-etching systems tending to show higher bond strengths than the other materials tested - and the location of the dentin, with significantly higher SBS being found on buccal surfaces in 3 of the 7 tested bonding systems.

Effect of cavity varnish, amalgam liner or dentin bonding agents on the marginal leakage of amalgam restorations.

The purpose of this in vitro study was to compare marginal leakage of Class II amalgam restorations lined with different agents (two new generation dentin bonding systems, a cavity varnish and an amalgam liner). Forty freshly extracted human molar teeth were divided into five groups. Class II preparations were prepared in the mesial and distal surfaces of each molar. While the cavities in two groups were lined with two new generation bonding systems, the other two groups were treated with an amalgam lining material and a cavity varnish. Fifth group was used as control, without any lining. Amalgam* was hand-condensed into each preparation. Specimens were thermocycled, stained and sectioned. Microleakage was graded using a stereomicroscope. Mean microleakage scores for occlusal and cervical margins were calculated and analysed. For the leakage values on occlusal margins, Kruskal-Wallis test indicated no significant difference in all groups. For the leakage values on cervical margins, Kruskal-Wallis test indicated significant difference in four groups when compared with controls (P < 0.001). On the other hand, there was no significant difference between the occlusal and cervical leakage values in each group.

Evaluation of retinoic acid ophthalmic emulsion in dry eye.

PURPOSE: An oil in water emulsion of 0.01% all-trans-retinoic acid (tretinoin) was prepared and clinically evaluated in dry eye patients. METHODS: The ophthalmic emulsion consisted of 10% of arachis oil and 90% of the hydrogel of Carbopol 940. To evaluate retinoic acid emulsion clinically, a placebo-controlled, open-labeled, randomized study was performed with 22 dry-eye patients. Symptoms were recorded before and after the treatments. The Schirmer I test, measurement of tear film break-up time (BUT), rose Bengal and fluorescein staining of cornea and conjunctiva, and mucus fern test were done. RESULTS: Retinoic acid did not improve the dryness, photophobia and foreign body sensation more than placebo. Schirmer test and BUT were significantly improved by retinoic acid treatment. Corneal and conjunctival epithelium maintained their characteristics during the use of retinoic acid, as indicated by rose Bengal and fluorescein staining. CONCLUSIONS: Ophthalmic emulsion of retinoic acid can be suggested as a promising approach for the treatment of dry eye.

Role of the vitreous in age-related macular degeneration.

PURPOSE: To investigate the relationship between posterior vitreous detachment (PVD) and age-related macular degeneration (AMD). METHODS: The condition of the vitreous was examined by slit-lamp funduscopy and ultrasonography in 93 eyes of 50 patients with AMD (exudative or dry) and 100 eyes of 50 controls. RESULTS: There was complete PVD in 31 of the 93 eyes (33.3%) of 50 patients with AMD and the posterior vitreous was attached in 62 of these eyes (66.6%). In the control group, in 50 eyes (50%) of 50 subjects there was posterior vitreous detachment. The prevalence of PVD in eyes with macular degeneration was significantly lower (P < .05). There was no statistically significant difference between the exudative and the nonexudative groups in respect to PVD. CONCLUSIONS: PVD may have a protective role against the development of AMD. Chronic vitreomacular traction and/or continuous exposure to free radicals and cytokines may possibly be one of the causes of AMD in eyes with attached vitreous.