Anatomical and functional outcomes of symptomatic idiopathic vitreomacular traction

Purpose: To describe the natural history of eyes with symptomatic idiopathic vitreomacular traction (VMT). Methods: Retrospective multicenter study of 168 eyes with spectral-domain optical coherence tomography (SD-OCT) findings consistent with idiopathic VMT. All eyes were graded according to SD-OCT...

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Autores:
Tipo de recurso:
Fecha de publicación:
2016
Institución:
Universidad del Rosario
Repositorio:
Repositorio EdocUR - U. Rosario
Idioma:
eng
OAI Identifier:
oai:repository.urosario.edu.co:10336/22939
Acceso en línea:
https://doi.org/10.1097/IAE.0000000000001015
https://repository.urosario.edu.co/handle/10336/22939
Palabra clave:
Aged
Article
Best corrected visual acuity
Central macular thickness
Female
Follow up
Human
Idiopathic disease
Major clinical study
Male
Medical history
Multicenter study
Observational study
Outcome assessment
Retina macula hole
Retina maculopathy
Retrospective study
Spectral domain optical coherence tomography
Visual acuity chart
Vitreomacular traction syndrome
Vitreous body
Vitreous disease
Clinical trial
Complication
Optical coherence tomography
Pathophysiology
Physiology
Remission
Retinal diseases
Retinal perforations
Slit lamp
Tissue adhesions
Visual acuity
Vitrectomy
Vitreous detachment
Fibrinolytic agent
Ocriplasmin
Peptide fragment
Plasmin
Aged
Female
Fibrinolysin
Fibrinolytic agents
Humans
Male
Peptide fragments
Retinal diseases
Retinal perforations
Retrospective studies
Slit lamp
Tissue adhesions
Visual acuity
Vitrectomy
Vitreous detachment
Macular hole
Ocriplasmin
Vitrectomy
Vitreomacular traction
optical coherence
spontaneous
Remission
Tomography
Rights
License
Abierto (Texto Completo)
Description
Summary:Purpose: To describe the natural history of eyes with symptomatic idiopathic vitreomacular traction (VMT). Methods: Retrospective multicenter study of 168 eyes with spectral-domain optical coherence tomography (SD-OCT) findings consistent with idiopathic VMT. All eyes were graded according to SD-OCT findings. Grade 1 was defined as incomplete cortical vitreous separation with foveal attachment. Grade 2 was defined as Grade 1 plus intraretinal cysts or clefts. Grade 3 was defined as Grade 2 plus a foveal detachment. All patients were followed for at least 6 months. Results: There were 168 patients (51 men) with a mean age of 68.8 ± 10.7 years. Patients were followed for a mean of 22.7 ± 20.1 months. The mean duration of symptoms before the initial presentation was 3.65 ± 5.42 months. At baseline, 72 eyes had Grade 1, 74 eyes had Grade 2, and 22 eyes had Grade 3 SD-OCT findings. Over the follow-up period, 36 eyes (21.4%) had spontaneous resolution of the VMT with normalization of the foveal anatomy. The mean time to resolution was 12.3 ± 12.6 months. An unfavorable anatomical outcome occurred in 7.7% (13 of 168) of the eyes, with 6 eyes developing a lamellar macular hole and 7 eyes developing a full-thickness macular hole. This occurred at a mean of 10.3 ± 10.7 months after the presentation. Subgroup analysis based on baseline SD-OCT grade showed that 4.1% (3 of 73) of Grade 1 eyes compared with 6.8% (5 of 74) of Grade 2 eyes, and 23.8% (5 of 21) of Grade 3 eyes developed a full-thickness macular hole or lamellar macular hole (P 0.0109, chi-square test). In the remaining 119 eyes, at the last follow-up, 65 eyes had Grade 1, 42 eyes had Grade 2, and 12 eyes had Grade 3 VMT. On average, the best-corrected visual acuity improved from 0.40 ± 0.35 logarithm of the minimum angle of resolution (Snellen, 20/50) at baseline to 0.35 ± 0.36 logarithm of the minimum angle of resolution (Snellen, 20/45; P 0.0372), and the mean central macular thickness improved from 350 ± 132 m to 323 ± 121 m. Conclusion: Spontaneous resolution of VMT occurred in 21.4% (36 of 168) of eyes after a mean follow-up of 11.4 ± 12.6 months. An unfavorable anatomical outcome occurred in 7.7% (13 of 168) of eyes. The baseline SD-OCT grade may predict the progression to full-thickness macular hole.