What is the mean age for vitreous (vitreous humor) detachment?

Mean Age for Posterior Vitreous Detachment

Posterior vitreous detachment (PVD) typically occurs between the ages of 45 and 65 in the general population, with earlier onset in men than women. 1

Age Distribution of PVD

PVD is an age-related process that represents the separation of the posterior vitreous cortex from the internal limiting membrane of the retina. The prevalence increases significantly with age:

• Ages 45-65: Primary age range when most PVDs occur in the general population 1
• Ages 65-85: PVD occurs in approximately 65% of individuals in this age group 2
• Age 70+: Studies suggest nearly 100% of highly myopic patients have PVD by this age 3

Factors Affecting Age of Onset

Several factors can accelerate the development of PVD:

• Gender: Some evidence suggests earlier onset in men compared to women 1
• Myopia:
  • High myopia (>-6 diopters) leads to PVD approximately 10 years earlier than in emmetropic eyes 3
  • In severe high myopia (>-10 diopters), PVD develops even earlier than in moderate high myopia 3
• Other risk factors:
  • Trauma
  • Previous ocular surgery (particularly cataract surgery)
  • Ophthalmic surgical procedures 1
  • Diabetes
  • Hereditary vitreoretinal degeneration 2

Age-Related Prevalence Data

Research provides the following prevalence patterns:

• Ages 65-69: Only 11% have complete PVD, while 71% still have completely attached vitreous 4
• Ages 80-89: 46% have complete PVD, 11% have partial PVD, and 43% still have completely attached vitreous 4

For high myopia patients:

• No PVD in patients 29 years or younger
• Prevalence increases with age: 23% (30s), 29% (40s), 44% (50s), 72% (60s), 100% (70+ years) 3

For emmetropic patients:

• No PVD in patients 39 years or younger
• Prevalence increases with age: 8% (40s), 23% (50s), 44% (60s), 74% (70s), 86% (80+ years) 3

Clinical Implications

Understanding the mean age of PVD onset is important because:

1. PVD can lead to retinal tears in 8-22% of patients at initial presentation 1
2. Patients with acute PVD symptoms should be examined promptly to detect and treat associated retinal breaks
3. Patients with PVD symptoms but no retinal breaks have a 2-5% chance of developing breaks in the following weeks 1
4. Early detection and treatment of retinal breaks can prevent progression to retinal detachment

Important Caveats

• Population-based studies on PVD incidence and prevalence are difficult to conduct due to lack of definite clinical signs and unreliable clinical tests 1
• PVD is actually less common in elderly patients than previously thought, with 43% of patients aged 80-89 still having completely attached vitreous 4
• The presence of symptoms (flashes, floaters) should prompt immediate examination regardless of age
• Patients with risk factors should be monitored more closely, as PVD may occur at an earlier age

When evaluating a patient with suspected PVD, thorough peripheral retinal examination is essential to detect any associated retinal breaks that may require treatment to prevent retinal detachment.