June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
Clinical Course of Unoperated Eyes with Vitreofoveal Traction
Author Affiliations & Notes
  • Vishak John
    Ophthalmology, Bascom Palmer Eye Institute, Miami, FL
  • Harry Flynn
    Ophthalmology, Bascom Palmer Eye Institute, Miami, FL
  • William Smiddy
    Ophthalmology, Bascom Palmer Eye Institute, Miami, FL
  • Adam Carver
    Ophthalmology, University of Oklahoma, Oklahoma City, OK
  • Robert Leonard
    Ophthalmology, University of Oklahoma, Oklahoma City, OK
  • Homayoun Tabandeh
    Retina, Retina Vitreous Associates Medical Group, Los Angeles, CA
  • David Boyer
    Retina, Retina Vitreous Associates Medical Group, Los Angeles, CA
  • Footnotes
    Commercial Relationships Vishak John, None; Harry Flynn, None; William Smiddy, None; Adam Carver, None; Robert Leonard, None; Homayoun Tabandeh, Alcon (C), Allergan (C); David Boyer, Alcon (C), Allegro (C), Allergan (C), Bayer (C), Genentech (C), Glaukos (C), GSK (C), Neurotech (C), Optos (C), Regeneron (C)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 2786. doi:https://doi.org/
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      Vishak John, Harry Flynn, William Smiddy, Adam Carver, Robert Leonard, Homayoun Tabandeh, David Boyer; Clinical Course of Unoperated Eyes with Vitreofoveal Traction. Invest. Ophthalmol. Vis. Sci. 2013;54(15):2786. doi: https://doi.org/.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: The purpose of the study was to investigate the unoperated clinical course of patients with vitreofoveal traction [VFT] in terms of visual acuity and anatomy using spectral domain optical coherence tomography [SD-OCT].

Methods: A multi-center, non-comparative chart review was performed of VFT patients examined between 2004 and 2012 who had SD-OCT findings consistent with vitreofoveal traction but for whom the attending physician elected observational management. VFT was graded based on OCT findings at initial and follow-up examinations. Fellow eyes of macular hold patients and patients with advanced macular disease affecting vision were excluded. Stage 1 was incomplete cortical vitreous separation with attachment at the fovea; Stage 2 was Stage 1 findings along with any intraretinal cysts or clefts; and Stage 3 was the same as Stage 2, but also included the presence of subretinal fluid. Best-corrected visual acuity (BCVA) was recorded at each examination.

Results: In the current study, 107 eyes of 86 patients were identified as having VFT by SD-OCT at three retina clinics. The mean age was 72.7 years. The mean time of follow-up was 708 days or 23 months [range 1 to 91 months]. At their initial visit, patients had a mean BCVA of log 0.268 [20/37 with a range 20/20 to 20/200] , and 44 eyes [41%] had Stage 1 VFT, 55 eyes [51%] with Stage 2, and 8 eyes [7%] with Stage 3 VFT. Spontaneous vitreous separation from the foveal attachment occurred in 31% of patients. During the study follow-up, four eyes underwent vitrectomy and membrane peel due to progression to a macular hole, and another eye for progressive visual loss. At the last examination, the mean BCVA remained stable from baseline.

Conclusions: The unoperated clinical course of idiopathic VFT is generally favorable when the presenting visual acuity is relatively good and symptoms are mild. Approximately one-fourth of patients resolved spontaneously at a mean follow-up of 15 months. Thus, non-interventional therapy should be considered in patients with idiopathic VFT.

Keywords: 763 vitreous • 585 macula/fovea • 692 retinal adhesion  
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