Abstract
Abstract: :
Purpose: To analyze the relationship between the retina and the vitreous in exudative AMD patients. Patients and Methods: The retina of 52 exudative AMD patients has been serially scanned by OCT3 before and after PDT treatment with Visudyne and vitreo-retinal features recorded and compared with photos of fundus and data of fundus examination. Results: 66 eyes of 52 patients (19 men, 33 women, mean age 75 years), have been examined. Among them, 2 eyes presented a complete vitreous detachment, 13 did not present any visible posterior hyaloid on OCT scans and 43 (65%) presented an anomalous vitreous attachment to the macula region. This was visualized as a hypereflective straight line over the retina sometimes bridging to non-contiguous retinal areas. Only 12 out of these 43 eyes presented clinical evidences of epi-retinal membranes. Among the 39 eyes examined before and after PDT, 20 had vitreous abnormal attachments before treatment and those which had not did not develop any after one or more treatment. Discussion: Exudative AMD eyes present a high prevalence of abnormalities of the vitreo-retinal interface as observed in the majority of long-course inflammatory diseases. The modifications of the interface are probably secondary to inflammatory components delivered by the underlying tissues and by the neovascular structures. The treatment by PDT seems to be irrelevant as regard to vitreo-retinal attachments. These findings can explain the persistence of metamorphopsia even after the resolution of the exudative retinal detachment.
Keywords: vitreous • age-related macular degeneration • inflammation