Clinical Ophthalmology (Jan 2020)
Clinical Features of Vitreomacular Traction Syndrome with Peripheral Vitreoretinal Adhesion
Abstract
Masanori Fukumoto, Takaki Sato, Shou Oosuka, Teruyo Kida, Hidehiro Oku, Tsunehiko Ikeda Department of Ophthalmology, Osaka Medical College, Takatsuki-City, Osaka, JapanCorrespondence: Tsunehiko IkedaDepartment of Ophthalmology, Osaka Medical College, 2-7 Daigaku-Machi, Takatsuki-City, Osaka 569-8686, JapanTel +81-72-684-6434Fax +81-72-682-0995Email [email protected]: To retrospectively review and analyze the clinical and imaging data of patients with vitreomacular traction syndrome (VMTS) with strong peripheral vitreoretinal adhesion.Subjects and Methods: This retrospective case-series study involved 4 eyes of 4 VMTS patients with vitreoretinal adhesion in both the macular region and the periphery who underwent vitreous surgery. In all 4 cases, preoperative refraction, fundoscopic findings, optical coherence tomography (OCT) findings, and intraoperative findings were evaluated.Results: The preoperative fundoscopy and OCT findings revealed fibrous membranes around the optic nerve head in 3 eyes. Thickened posterior vitreous membranes extending from the posterior pole to the periphery were observed in all eyes. Apparent VMTS or epimacular membrane was also found in the fellow eyes of 2 patients. The preoperative refractive errors ranged from +0.5 diopters (D) to +2.75 D (mean, +1.13 D). Intraoperatively, a thickened posterior vitreous membrane was found strongly adhered to the retina in the macula regions, optic nerve head, and periphery. In 2 eyes, when artificial posterior vitreous detachment (PVD) was created, an iatrogenic tear developed in the periphery.Conclusion: The features of VMTS that cause strong peripheral vitreoretinal adhesion include the preoperative presence of a thickened posterior vitreous membrane over a wide area, hypermetropia, and a short axial length.Keywords: hypermetropic, iatrogenic tear, peripheral vitreoretinal adhesion, posterior vitreous detachment, vitreomacular traction syndrome, vitreous surgery