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Vishak J. John, William Smiddy, Harry Flynn; Natural Clinical Course Of Unoperated Eyes With Vitreomacular Traction Syndrome. Invest. Ophthalmol. Vis. Sci. 2012;53(14):5220.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate the unoperated clinical course of eyes with vitreomacular traction syndrome in terms of anatomic and visual outcomes.
A consecutive case series of patients who presented to the Retina Service at Bascom Palmer Eye Institute between 2007 and 2011 who had OCT findings consistent with vitreomacular traction. At the initial visit, demographic information, vision, symptoms, and OCT were collected. Vitreomacular traction was graded based on OCT findings at initial and follow up visit.
38 eyes of 26 patients were identified as having vitreomacular traction by SD-OCT on their initial visit. The mean age of the patients was 75 years, with an even split of 13 males and 13 females. The mean follow up was 589 days [range 71 to 1652 days]. At initial visit, patients had a mean BCVA of 20/50, and 13 eyes [34%] had Grade I VMT[no cysts], 20 eyes [53%] had Grade II VMT with cysts, and 5 eyes [13%] presented with Grade III VMT with subretinal fluid. During the time of follow up, only one eye underwent surgery due to worsening vision. At final visit, the best corrected vision was 20/40 [p=0.014 when compared to baseline vision], with 24 eyes [64%] remaining stable by OCT. Only 5 eyes [13%] worsened in their anatomic VMT grading by OCT. Finally, all remaining 37 eyes at final visit are being observed.
Unoperated clinical course of vitreomacular traction is relatively stable over the course of the 16 month mean follow up in this study. Mean initial and last follow up visual acuity were similar. There was a low rate of progression from mild to severe grades of VMT that may need vitreoretinal surgery. Many if not most VMT patients can be followed nonsurgically; surgical indications are not clearly defined but surgery might be considered for eyes with progressive visual or anatomic worsening. In addition, nonsurgical, injection therapies are now becoming available, but indications for its use have not been well established.
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