Remodelling of the human vitreous and vitreoretinal interface – A dynamic process

The highly hydrated, almost acellular vitreous body of the human eye consists of only 0.1% macromolecules, of which collagens are the most important for its matrix structure. During embryological development, the human vitreous body is a highly dynamic matrix, in which the primary (vascular) vitreous is gradually replaced by the secondary (avascular) vitreous. With aging, the human vitreous undergoes a slowly progressive remodelling, characterized by the gradual formation of collagenous condensations and liquefied spaces in the gel structure. The former is probably the result of collagen synthesis and the deposition of newly formed collagen into the matrix, while the latter is probably due to collagen breakdown. Therefore, remodelling of the vitreous matrix starts at a very early age and continues into old age, albeit at a slower pace. Older theories and concepts of a strict spatial separation between the primary and secondary vitreous during embryonic development, and morphological changes in the aging vitreous being due to a simple aggregation of collagen fibrils are questioned. This review describes the embryological and postnatal remodelling of the human vitreous matrix and vitreoretinal interface, in addition to the mechanisms and cells that are potentially involved in this process.