ANATOMICAL AND FUNCTIONAL OUTCOMES OF SYMPTOMATIC IDIOPATHIC VITREOMACULAR TRACTION: A Natural History Study From the Pan American Collaborative Retina Study Group

ANATOMICAL AND FUNCTIONAL OUTCOMES OF SYMPTOMATIC IDIOPATHIC VITREOMACULAR TRACTION: A Natural History Study From the Pan American Collaborative Retina Study Group

Author Wu, Lihteh Google Scholar
Zas, Marcelo Google Scholar
Berrocal, Maria H. Google Scholar
Arevalo, J. Fernando Google Scholar
Figueroa, Marta Google Scholar
Rodriguez, Francisco Google Scholar
Serrano, Martin Google Scholar
Graue, Federico Google Scholar
Alezzandrini, Arturo Google Scholar
Gallego-Pinazo, Roberto Google Scholar
Roca, Jose A. Google Scholar
Iglicki, Matias Google Scholar
Dalma-Weishauz, Jose Google Scholar
Kozak, Igor Google Scholar
Collado, Alberto Google Scholar
Badal, Josep Google Scholar
Maia, Mauricio Autor UNIFESP Google Scholar
Salcedo-Villanueva, Guillermo Google Scholar
Quiroz-Mercado, Hugo Google Scholar
Fromow-Guerra, Jans Google Scholar
Lozano-Rechy, David Google Scholar
Avila, Marcos Google Scholar
Chhablani, Jay Google Scholar
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 m to 323 +/- 121 m.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 vitreomacular traction
macular hole
vitrectomy
ocriplasmin
xmlui.dri2xhtml.METS-1.0.item-coverage Philadelphia
Language English
Date 2016
Published in Retina-The Journal Of Retinal And Vitreous Diseases. Philadelphia, v. 36, n. 10, p. 1913-1918, 2016.
ISSN 0275-004X (Sherpa/Romeo, impact factor)
Publisher Lippincott Williams & Wilkins
Extent 1913-1918
Origin http://dx.doi.org/10.1097/IAE.0000000000001015
Access rights Closed access
Type Article
Web of Science ID WOS:000385998600026
URI https://repositorio.unifesp.br/handle/11600/56988

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