Anatomical and functional outcomes of symptomatic idiopathic vitreomacular traction
Por:
Wu L., Zas M., Berrocal M.H., Arevalo J.F., Figueroa M., Rodriguez F., Serrano M., Graue F., Alezzandrini A., Gallego-Pinazo R., Roca J.A., Iglicki M., Dalma-Weishauz J., Kozak I., Collado A., Badal J., Maia M., Salcedo-Villanueva G., Quiroz-Mercado H., Fromow-Guerra J., Lozano-Rechy D., Avila M., Chhablani J.
Publicada:
1 ene 2016
Resumen:
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.
Filiaciones:
Asociados de Macula, Vitreous and Retina Assoc. of Costa Rica, Apdo 144-1225 Plaza Mayor, San José, Costa Rica
University of Buenos Aires, Argentina
University of Puerto Rico, San Juan, Puerto Rico
King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD, United States
Retina Department, Ramón y Cajal University Hospital, Madrid, Spain
VISSUM Madrid, Madrid, Spain
National Ophthalmological Foundation, Rosario University, Bogota, Colombia
Centro Caracas Ophthalmologic Clinic, Caracas, Venezuela
Conde Valenciana Foundation, Mexico City, Mexico
OFTALMOS University of Buenos Aires, Buenos Aires, Argentina
La Fe Hospital, University of Valencia, Valencia, Spain
Ricardo Palma Clinic, Lima, Peru
Association for Blindness Prevention in Mexico, Mexico City, Mexico
Retina and Vitreous Unit, Department of Ophthalmology, Moises Broggi Hospital, Barcelona, Spain
Department of Ophthalmology, Vision Institute, Federal University of Sao Paulo, Sao Paulo, Brazil
University of Colorado, School of Medicine, Denver, CO, United States
Department of Ophthalmology, Federal University of Goias, Goiânia, Brazil
LV Prasad Eye Institute, Hyderabad, India
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