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Agustina Palacio, Akash Gupta, Puja Jadav, Brooke L W Nesmith, Shlomit Schaal; Vitreo-macular Adhesion and Posterior Vitreous Detachment Evolution during Normal Aging of Human Eyes. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):4330.
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© ARVO (1962-2015); The Authors (2016-present)
To characterize the normal evolutions of vitreomacular adhesion (VMA) and posterior vitreous detachment (PVD) through nine decades of life in healthy subjects.
Four hundred healthy subjects aged 10-97 years, with best corrected visual acuity better than 20/40 and no ocular pathology on clinical examination or imaging were included. 3,452 spectral domain optical coherence tomography (SD-OCT, Spectralis®, Heidelberg Engineering) of 25-raster foveal scans were reviewed. Area of VMA was delineated using the drawing tool of the Spectralis® and calculated in mm2 for each subject. A retrospective chart review was performed, data collected included gender, race, best corrected visual acuity (BCVA), refractive error, lens status, and posterior vitreous detachment status. Subjects were subsequently divided into 9 age groups according to decade of life (10-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80-89, 90-99 years). Statistical analysis was carried out using SPSS software (Version 17.0; SPSS Inc., Chicago, IL). Multivariate analysis was performed using the two way ANOVA analysis.
Five hundred sixty-six SD-OCT scans were analyzed. Area of VMA (mm2) decreased sigmoidally (R2=0.99) with each decade of life (35±0, 34.5±4, 32.6±6.7, 28.8±11.3, 14.9±14.1, 4.6±9.7, 2.2±8.8, 0.9±5.1, 0±0 mm2). With aging, percentage of PVD increased (0, 0, 0, 1.5, 19.8, 65.7, 73.7, 91.7, 100%) while percentage of complete vitreous attachment decreased (100, 98.4, 88.2, 75.8, 30.9, 8.1, 6.6, 2.1, 0%). Incidence of VMA peaked in the 6th decade of life (0, 1.6, 11.8, 22.7, 49.4, 26.3, 19.7, 6.3, 0%). Males were found to have significantly larger area of VMA (mm2) compared to females in the 5th through 8th decades of life, P<0.05. Women reached 50% VMA at age 55 years, while men at age 65 years. No correlation was found between area of VMA and lens status, race, BCVA, or refractive error of the subjects for each decade of life.
This study is the first to demonstrate and quantify the evolution of VMA and PVD throughout normal aging. The vitreo-macular interface interactions throughout life are gender dependent. This adds to our current understanding of the normal aging process undergone by the vitreous.
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