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A.J. Flug, H.M. Engel, D. Chechik, U. Mian; Detection of Clinically Occult Vitreomacular Traction in Patients With Clinically Significant Macular Edema (CSME) Using Optical Coherence Tomography (OCT) . Invest. Ophthalmol. Vis. Sci. 2005;46(13):2589.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To determine 1) the sensitivity of OCT compared with standard clinical examination in detecting vitreomacular traction in patients with CSME and 2) the overall prevalence of vitreomacular traction in these patients. Methods: Thirty–two eyes in 23 non–consecutive patients with CSME were examined using slit–lamp biomicroscopy for evidence of posterior vitreous detachment (PVD) or retinal surface changes, including epiretinal membranes (ERM). Patients then underwent OCT scans of the macula and optic nerve to assess for the same. Baseline data collected included age, type and duration of diabetes and severity of retinopathy, best–corrected visual acuity, and history of prior laser treatments. Results: On clinical examination, 8/32 (25%) had PVD; 0/32 (0%) had epiretinal membranes or surface change. On OCT, 22 (68.75%) had an intact vitreous, 8 (25%) had partial PVD, and 2 (6.25%) were indeterminate. Five eyes (15.6%) had apparent vitreomacular traction (VMT) and 2 (6.25%) had probable VMT. Patients with partial PVD on OCT were 16.5 times more likely to have apparent or probable VMT than those with an intact vitreous (RR=16.5; 95% CI 2.33 – 117). Among those previously treated with focal laser photocoagulation, 6/12 (50%) had VMT, compared with only 1/20 (5%) eyes not previously treated. Conclusions: OCT is more sensitive than standard clinical examination at detecting VMT. The prevalence of VMT in patients with CSME is over 15% and is more common in patients refractory to focal laser photocoagulation.
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