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 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.

• 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
• License: Abierto (Texto Completo)