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ANATOMICAL AND FUNCTIONAL OUTCOMES OF SYMPTOMATIC IDIOPATHIC VITREOMACULAR TRACTION
Author(s)
Johns Hopkins University
Marcelo Zas
Johns Hopkins University
María H. Berrocal
Johns Hopkins University
J. Fernando Arévalo
Johns Hopkins University
Marta S. Figueroa
Johns Hopkins University
Francisco J. Rodríguez
Johns Hopkins University
Martín Serrano
Johns Hopkins University
Federico Graue
Johns Hopkins University
Arturo Alezzandrini
Johns Hopkins University
Roberto Gallego‐Pinazo
Johns Hopkins University
José A. Roca
Johns Hopkins University
Matías Iglicki
Johns Hopkins University
José Dalma-Weishauz
Johns Hopkins University
Igor Kozak
Johns Hopkins University
Alberto Collado
Johns Hopkins University
Josep Badal
Johns Hopkins University
Maurício Maia
Johns Hopkins University
Guillermo Salcedo-Villanueva
Johns Hopkins University
Hugo Quiroz-Mercado
Johns Hopkins University
Jans Fromow-Guerra
Johns Hopkins University
David Lozano-Rechy
Johns Hopkins University
Marcos Pereira de Ávila
Johns Hopkins University
Jay Chhablani
Johns Hopkins University
Date Issued
11 de marzo de 2016
Type
Article
Volume
36
Issue
10
Series/Report No.
Retina
Start Page
1913
End Page
1918
ISSN
0275-004X
1539-2864
Abstract
PURPOSE: To describe the natural history of eyes with symptomatic idiopathic vitreomacular traction (VMT). METHODS: Retrospective multicenter study of 168 eyes with spectral-domain optical coherence tomography (SD-OCT) findings consistent with idiopathic VMT. All eyes were graded according to SD-OCT findings. Grade 1 was defined as incomplete cortical vitreous separation with foveal attachment. Grade 2 was defined as Grade 1 plus intraretinal cysts or clefts. Grade 3 was defined as Grade 2 plus a foveal detachment. All patients were followed for at least 6 months. RESULTS: There were 168 patients (51 men) with a mean age of 68.8 ± 10.7 years. Patients were followed for a mean of 22.7 ± 20.1 months. The mean duration of symptoms before the initial presentation was 3.65 ± 5.42 months. At baseline, 72 eyes had Grade 1, 74 eyes had Grade 2, and 22 eyes had Grade 3 SD-OCT findings. Over the follow-up period, 36 eyes (21.4%) had spontaneous resolution of the VMT with normalization of the foveal anatomy. The mean time to resolution was 12.3 ± 12.6 months. An unfavorable anatomical outcome occurred in 7.7% (13 of 168) of the eyes, with 6 eyes developing a lamellar macular hole and 7 eyes developing a full-thickness macular hole. This occurred at a mean of 10.3 ± 10.7 months after the presentation. Subgroup analysis based on baseline SD-OCT grade showed that 4.1% (3 of 73) of Grade 1 eyes compared with 6.8% (5 of 74) of Grade 2 eyes, and 23.8% (5 of 21) of Grade 3 eyes developed a full-thickness macular hole or lamellar macular hole (P = 0.0109, chi-square test). In the remaining 119 eyes, at the last follow-up, 65 eyes had Grade 1, 42 eyes had Grade 2, and 12 eyes had Grade 3 VMT. On average, the best-corrected visual acuity improved from 0.40 ± 0.35 logarithm of the minimum angle of resolution (Snellen, 20/50) at baseline to 0.35 ± 0.36 logarithm of the minimum angle of resolution (Snellen, 20/45; P = 0.0372), and the mean central macular thickness improved from 350 ± 132 μm to 323 ± 121 μm. CONCLUSION: Spontaneous resolution of VMT occurred in 21.4% (36 of 168) of eyes after a mean follow-up of 11.4 ± 12.6 months. An unfavorable anatomical outcome occurred in 7.7% (13 of 168) of eyes. The baseline SD-OCT grade may predict the progression to full-thickness macular hole.
Keywords