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Emilia Maggio, Antonio Polito, Barbara Parolini, Grazia Pertile; Vitreomacular Adhesion is not a Further Risk Factor for Neovascular Age-related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2011;52(14):101.
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To evaluate the role of abnormal and persistent vitreomacular adhesion in the pathogenesis of neovascular age-related macular degeneration (AMD) and in the response to anti-vascular endothelial growth factor (anti-VEGF) therapy.
A total of 200 eyes of 144 patients (mean age 77.3 ± 7.8 years) with neovascular AMD and 203 eyes of 169 patients (mean age 74.7 ± 8.1 years) included as control group were examined with Spectral Domain scanning laser ophthalmoscope and optical coherence tomography (SD-OCT). All patients were studied to identify the presence of vitreomacular adhesion. Main outcome measures were the number of eyes with posterior vitreous detachment (PVD), vitreomacular traction (VMT), and persistent vitreomacular adhesion to the macula with a non-tractional configuration (VMANT). Together the VMANT and VMT subgroups formed the VMA group, including all eyes with persistent vitreomacular adhesion. Characteristics of the vitreoretinal interface in the group of eyes affected by neovascular AMD exhibiting a resistance to therapy with anti-VEGF were carefully evaluated.
VMA was present in 59 (29,5 %) eyes with neovascular AMD and in 66 (32,5 %) control eyes. VMT was present in 6 (3 %) eyes with neovascular AMD and in 7 (3,4 %) control eyes. In the group affected by neovascular AMD, eyes with VMA have not been found to have a different response to anti-VEGF therapy.
Eyes with neovascular AMD do not exhibit a higher prevalence of vitreoretinal interface abnormalities compared to elder normal eyes. These findings suggest that persistent VMA may not have a role in the pathogenesis of neovascular AMD nor in the resistance to anti-VEGF therapy. Surgically induced PVD is not a sufficiently supported strategy for the treatment of the disease.
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