Purchase this article with an account.
Brooke L W Nesmith, Agustina C Palacio, Yam Schaal, Akash Gupta, Shlomit Schaal; Changes in Vitreomacular Attachment with Aging: A Comparison Between Healthy Patients and Diabetics. Invest. Ophthalmol. Vis. Sci. 2016;57(12):4054.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To compare the natural progression of vitreomacular attachment (VMA) with aging between healthy subjects and diabetics.
400 healthy patients aged 10-97 years, with best corrected visual acuity (BCVA) ≥ 20/40 were included. 141 aged matched diabetic patients, without evidence of cystoid macular edema were included. 25 raster foveal spectral domain optical coherence tomography (SD-OCT, Spectralis®, Heidelberg Engineering) scans were performed on every subject. Foveal scans demonstrating pathology or cystoid macular edema were excluded. Area of VMA was delineated using the Spectralis® drawing tool and calculated in mm2. Data collected included gender, race, BCVA, lens status, and posterior vitreous detachment (PVD) status. Subjects were divided into age groups according to decade of life. VMA areas were compared between healthy subjects and diabetics in each decade.
A total of 541 SD-OCT scans were analyzed. Area of VMA (mm2) decreased sigmoidally with each decade of life in healthy patients (Mean 35± SD 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), a hyperbolic decline was noticed in diabetics (35.5±0, 35.0±3, 34.0±3, 33.9±5, 33.7±6, 29.0±11, 23±15, 13±15). Statistical significance was noted between the groups during the 6th-8th decades (fig. 1). With aging, incidence of PVD increased and incidence of complete attachment decreased, but patterns differed significantly between healthy and diabetic patients (fig 2). In healthy patients, area of VMA (mm2) was significantly higher in males than females in the 5th-8th decades. In healthy patients, women reached 50% VMA at 55 years, men at 65 years. There was no significant correlation between area of VMA (mm2) and either lens status or race.
Diabetes affects the magnitude of attachment of the vitreous gel to the macula that results in stronger and longer lasting attachment of the gel throughout life. Gender differences in VMA progression were noticed in healthy patients, but not in diabetics, suggesting that VMA remains robust in both genders in diabetes despite aging.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
Area of vitreomacular adhesion (mm2) for each of decade of life in diabetics and healthy patients.
Percentage of patients with complete vitreomacular attachment (VMA), complete posterior vitreous detachment (PVD), and PVD with peristent VMA in healthy patients (left) and diabetics (right) for each decade of life.
This PDF is available to Subscribers Only