RESUMO
In vitreomacular traction syndrome (VMTS) an anomalous posterior vitreous detachment (APVD) with persistant symptomatic vitreoretinal adhesion is seen. The adhesion leads to a thickened macula, to macular oedema and a reduction of BCVA. Modern imaging techniques like spectral domain OCT (SD-OCT) allow a detailed imaging of the retinal microstructure and the vitreoretinal interface. Vitreomacular adhesions and their effect on the retina can be visualised. Until now, the treatment option for VMTS was and is vitreoretinal surgery. In studies pharmacological vitreolysis has shown a therapeutic effect in patients with symptomatic adhesion and traction. The results of these studies represent an important step towards a pharmacological treatment of VMTS.
Assuntos
Doenças Retinianas/diagnóstico , Doenças Retinianas/terapia , Aderências Teciduais/diagnóstico , Aderências Teciduais/terapia , Cirurgia Vitreorretiniana/métodos , Descolamento do Vítreo/diagnóstico , Descolamento do Vítreo/terapia , Humanos , SíndromeRESUMO
PURPOSE: The aim of this study was to evaluate posterior vitreomacular adhesion as a risk factor for choroidal neovascularisation (CNV) in age-related macular degeneration (AMD). The vitreoretinal interface was examined using spectralis optical coherence tomography (Spectralis-OCT, Heidelberg Engineering). PATIENTS AND METHODS: In a retrospective observational case series 375 consecutive eyes of 375 patients (age 51-90 years) were examined with spectralis OCT and fluorescein angiography (Spectralis-HRA, Heidelberg Engineering). Vitreomacular adhesion was defined when a posterior hyaloid line attached to the inner retinal surface was seen in OCT. In 202 patients with exudative AMD the incidence of posterior vitreomacular adhesion was compared to 173 control eyes (72 with non-exudative AMD and 101 eyes without retinal alterations). RESULTS: We found posterior vitreomacular adhesions in 151 patients (40.27â%). In the control group 53 patients (30.6â%) showed vitreomacular adhesions compared to 98 patients (48.5â%) with exudative AMD. The difference was statistically significant (p = 0.001). The location of vitreomacular adhesion was observed over the area of the CNV in 87 patients (88â%) with exudative AMD. CONCLUSIONS: Spectralis OCT allows a detailed examination of the vitreomacular interface. The frequency of posterior vitreomacular adhesion is significantly increased in eyes with CNV in AMD. Chronic vitreomacular traction may be a risk factor for the development of exudative AMD.