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Jonathan Tzu, Harry W Flynn, william smiddy, ; Outcomes of Vitrectomy for Vitreomacular Traction after an Initial Observation Period. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):1218.
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The purpose of this study is to investigate the clinical course and surgical outcomes of patients with vitreomacular traction (VMT) and managed initially by observation, but eventually underwent surgical intervention for development of a macular hole or worsening symptoms
The current study is a non-comparative, multicenter case series of patients with a diagnosis of VMT based on clinical symptoms and findings on spectral domain optical coherence tomography (SD-OCT) between the years of 2006 and 2013. All patients were initially observed but subsequently a small number of patients had surgery because of the development of full thickness macular hole or worsening symptoms. Follow-up including visual acuity, changes in SD-OCT findings, and time to surgery were recorded.
VMT by SD-OCT from 5 retina clinics was identified in 230 eyes of 185 patients. These patients were all managed by observation initially. Pars plana vitrectomy (PPV) was eventually performed in 10 of 230 eyes (4.1%). Six of the 10 eyes developed a macular hole, and 4 of the 10 eyes had worsening symptoms from VMT. The mean time of observation before PPV was 23.8 months (range 3 - 76 months). At last follow up, all of 6 the patients who developed a macular hole had successful surgical closure of the hole. The four patients with worsening VMT also had anatomic success- relief of the VMT postoperatively resulting in resolution of subretinal and intraretinal fluid. Postoperative best corrected visual acuities were ≥ 20/40 in 8 of 10 eyes.
After a period of initial observation, VMT patients undergoing surgical intervention achieved improved anatomic and visual outcomes.
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