Purchase this article with an account.
Jonathan Tzu, Vishak J John, Harry W Flynn, William Smiddy, Adam Carver, Robert Leonard, Homayoun Tabandeh, David S Boyer, Maria H Berrocal; Vitreomacular Adhesion: Clinical Course and Outcomes Managed by Initial Observation. Invest. Ophthalmol. Vis. Sci. 2014;55(13):323.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
The purpose of this study is to investigate the clinical course and outcomes of patients with vitreomacular adhesion (VMA) and managed initially by observation
The current study is a case series of patients with a diagnosis of vitreomacular adhesion based on clinical symptoms and findings on spectral domain optical coherence tomography (SD-OCT) between the years of 2005 and 2013. VMA was graded based on the degree of distortion of the foveal contour. Grade 1 is incomplete cortical vitreous separation with attachment at the fovea and visible distortion, Grade 2 is Grade 1 with any intraretinal cysts or clefts, and Grade 3 is Grade 2 findings with subretinal fluid beneath the fovea. Follow-up including visual acuity, changes in SD-OCT findings, and timing of the release of VMA as seen on SD-OCT were recorded.
VMA by SD-OCT from 4 retina clinics was identified in 139 eyes of 112 patients. Mean age was 73 years and mean time of follow up was 30 months. Baseline VMA grading was the following: Grade 1 - 52 eyes (37%), Grade 2 - 73 eyes (53%), and Grade 3 - 14 eyes (10%). By the last follow-up, spontaneous release of VMA occurred in 44 (32%) of eyes. Spontaneous release of VMA occurred at a mean of 16.8 months from initial visit and median of 9.8 months. At baseline, mean logMAR best corrected visual acuity (BCVA) was 0.26 (20/36) [range 20/20 to 20/200], and at last follow up was 0.28 (20/38) [range 20/20 to 20/400]. Pars plana vitrectomy was performed in 7 eyes (5.0%) [6 for macular hole, 1 for increased VMA] and BCVA outcomes were ≥ 20/40 in 6 of 7 eyes.
In the current study, patients generally had a favorable clinical course when managed by initial observation. Spontaneous release of VMA occurred in 32% of patients, and pars plana vitrectomy was performed in 5% of patients by last follow-up.
This PDF is available to Subscribers Only