Macular choriovitreal membrane and macular traction syndrome: comparison with clinical, fluorescein angiographic and optical coherence tomographic findings.

Abstract

 

Purpose

 

Macular choriovitreal membrane (MCVM) is an epiretinal fibrovascular membrane adherent to the posterior vitreous hyaloid extending from the subfoveal space. We intended to evaluate preoperative and postoperative clinical features, fluorescein angiographic and optical coherence tomographic findings of MCVM by comparing with those of macular traction syndrome (MTS).

 

Methods

 

Consecutive nine MCVM patients and 103 MTS patients underwent successful vitrectomy by one surgeon due to symptomatic macular traction were identified through a retrospective chart review. All clinical data were reviewed for underlying ocular and systemic conditions, visual acuity, optical coherence tomography (OCT), and fluorescein angiography (FA) findings.

 

Results

 

MCVM patients were younger than MTS patients (55.1 years vs. 63.6 years, p=0.040) and showed worse visual acuity (LogMAR 1.27 vs. 0.66, p=0.001). When compared with MTS patients, MCVM patients showed higher association with previous laser history (44.4% vs. 18.4%, p=0.025), ocular comorbidities (100.0% vs. 41.8%, p=0.001), and diabetes (66.7% vs. 19.4%, p=0.030). While subfoveal fibrous stalk and photoreceptor disruption were noted in all of OCT data in patients with MCVM, only 2 patients (1.9%) with MTS showed photoreceptor disruption. In FA, 7 cases of MCVM (71.3%) demonstrated definite hyperfluorescence. Both MCVM and MTS patients showed significant decrease in central retinal thickness postoperatively owing to successful removal of macular traction (p=0.001). Although MTS patients showed marked visual improvement postoperatively (p=0.001), MCVM patients did not (p=0.355). Rather, MCVM patients showed improvement of central vision subjectively.

 

Conclusions

 

MCVM is the rarely reported disorder caused by the various pathologic vitreoretinal conditions. It is important to distinguish MCVM from MTS with thorough preoperative examination, because of their different surgical approach and postoperative prognosis.

 

 

Optical coherence tomographic (OCT) findings of macular choriovitreal membrane and macular traction syndrome(MTS).

 

 

Fluorescein angiographic(FA) findings of macular choriovitreal membrane.

 

Keywords: 585 macula/fovea • 550 imaging/image analysis: clinical • 688 retina