![]() ![]() SD-OCT scans of a patient with VMT with varying Note the intact external limitingįigure 3. The outer retina remains intact and resembles Resulting in VMT distorting the subfoveal and perifoveal There is a focal area of abnormal adhesion SD-OCT scan of a patient with VMT depicting theĬolumn sign. Patients with VMT involving both the inner and outer retina (Figure 3) were unlikely to have spontaneous release of their retinal distortion.įigure 2. VMT with solely inner retina disruption is commonly referred to as possessing the column sign, owing to the outer retina being undisturbed in the configuration of two columns (Figure 2). Patients with spontaneous release of VMT were significantly more likely to have only inner retinal distortion ( P =. ![]() Over an observation period of approximately 1 year, we found that 21 of 61 (35%) patients experienced VMT resolution and 40 of 61 (65%) did not. Spontaneous resolution of VMT was defined as a release of traction from all macular points seen on OCT without vitrectomy or ocriplasmin injection. Patients with concurrent exudative AMD, DME, and macular edema associated with RVO received anti-VEGF injections independent of a diagnosis of VMT. Patients were classified as having combined inner and outer retina involvement if the outer retinal architecture was also involved. These patients also showed normal outer retinal anatomy, including a normal external limiting membrane and photoreceptor ellipsoid zone. Patients with inner retina distortion showed VMT causing abnormal inner retinal architecture up to, but not including, the outer nuclear layer. VMT was classified by the degree of inner-only versus both inner and outer retinal involvement. VMT was characterized for each patient as broad (> 400 µm) or focal (< 400 µm) based on horizontal OCT scans. We retrospectively investigated 61 patients with VMT as seen on optical coherence tomography (OCT) and excluded any patient with previous surgery or prior treatment with ocriplasmin (Jetrea, ThromboGenics). AfterĦ months of observation, the VMT resolved with improvedįoveal contour and normal inner retinal architecture (B). Note how the outer retina is unaffected (A). There is a focal area of abnormal adhesionĪt the fovea with associated traction and distortion of the (SD-OCT) scan of a patient with VMT and subsequent Spectral-domain optical coherence tomography 3 We aimed to identify predictive factors to aid clinicians in the decision of when to observe patients with VMT versus when to proceed with pars plana vitrectomy or pharmacologic vitreolysis.įigure 1. 2 Recently, we set out to determine which factors, if any, might predict or be associated with spontaneous separation and resolution of VMT. Previously, we and other authors have shown that spontaneous resolution of VMT without pharmacologic or surgical intervention occurs and may be associated with improvement in visual acuity and elimination of VMT symptomatology. In cases of VMT, tractional forces induce structural changes in the retina, leading to loss of central vision and metamorphopsia. 1 Vitreous traction on the macula is due to anomalous and incomplete posterior vitreous detachment, and it may be associated with other conditions such as age-related macular degeneration (AMD), diabetic macular edema (DME), or retinal vein occlusion (RVO). The prevalence of vitreomacular traction (VMT) associated with ocular disease has been estimated to range from 0.35% to 1.5% of the general population, suggesting a large disease burden and potentially large treatment demand. Likely to resolve than in patients with both inner Who only had inner retinal involvement was more In a small retrospective study, VMT in patients.Posterior vitreous detachment in patients Prior anti-VEGF use may predict spontaneous.Should take a patient's ocular history into Pharmacologic intervention to resolve VMT Retina specialists considering surgical or. ![]()
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