Ítem
Solo Metadatos
Anatomical and functional outcomes of symptomatic idiopathic vitreomacular traction
Título de la revista
Autores
Wu, Lihteh
Zas, Marcelo
Berrocal, Maria H.
Arevalo, J. Fernando
Figueroa, Marta
Rodriguez, Francisco
Serrano, Martin
Graue, Federico
Alezzandrini, Arturo
Gallego-Pinazo, Roberto
Fecha
2016
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Lippincott Williams and Wilkins
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Resumen
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.
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Keywords
Aged , Article , Best corrected visual acuity , Central macular thickness , Female , Follow up , Human , Idiopathic disease , Major clinical study , Male , Medical history , Multicenter study , Observational study , Outcome assessment , Retina macula hole , Retina maculopathy , Retrospective study , Spectral domain optical coherence tomography , Visual acuity chart , Vitreomacular traction syndrome , Vitreous body , Vitreous disease , Clinical trial , Complication , Optical coherence tomography , Pathophysiology , Physiology , Remission , Retinal diseases , Retinal perforations , Slit lamp , Tissue adhesions , Visual acuity , Vitrectomy , Vitreous detachment , Fibrinolytic agent , Ocriplasmin , Peptide fragment , Plasmin , Aged , Female , Fibrinolysin , Fibrinolytic agents , Humans , Male , Peptide fragments , Remission , Retinal diseases , Retinal perforations , Retrospective studies , Slit lamp , Tissue adhesions , Tomography , Visual acuity , Vitrectomy , Vitreous detachment , Macular hole , Ocriplasmin , Vitrectomy , Vitreomacular traction
