Crescent Journal of Medical and Biological Sciences (Jan 2019)

Comparing Pars Plana Vitrectomy and Observation for Vitreomacular Traction Syndrome

  • Mohammad Hossein Ahoor,
  • Leila Alizadeh Ghavidel,
  • Araz Mohammadzadeh

Journal volume & issue
Vol. 6, no. 1
pp. 91 – 95

Abstract

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Objectives: This study aimed to estimate the natural course of vitreomacular traction (VMT) disorder during a 6-month follow-up using the high-resolution spectral-domain optical coherence tomography (SD-OCT). In addition, it attempted to evaluate the visual and anatomical outcomes of the patients who underwent a follow-up or vitrectomy for VMT syndrome. Materials and Methods: In this prospective study, 45 eyes from 45 patients with VMT syndrome underwent SD-OCT imaging and eye examinations. All the patients were observed for the 6 subsequent months. Further, those patients who demonstrated no spontaneous resolution of adhesion during this period underwent 3 port standard pars plana vitrectomy. Two patients were excluded from the study, then all the remaining patients were observed for 12 months. The mean observation period of all the patients was 18 months. Changes in visual acuity (VA) before and after the study were compared between the 2 groups. Results: The mean age of patients was 64.21 ± 7.712 years (51-80 years). After 6 months follow-up, 20 patients (44.45 %) represented the spontaneous release of VTM. Furthermore, mean LogMAR VA improved from 0.7042 ± 0.21 (Snellen’s equivalent of 20/100) to 0.585 ± 78 (Snellen’s equivalent of 20/76). Baseline VA was greater than or equal to LogMAR VA of 0.7 (Snellen’s equivalent of 20/100) in most of the patients who revealed a spontaneous resolution of VMT after a six-month follow-up. Moreover, all the patients with spontaneous release of VMT, indicated improvement in VA compared to the baseline, from mean baseline LogMAR VA of 0.5650 (Snellen’s equivalent of 20/73) to 0.4700 (Snellen’s 20/59). Finally, the mean baseline LogMAR VA improved from 0.8435 (Snellen’s equivalent 20/138) to 0.7000 (Snellen’s equivalent 20/100) in vitrectomy group. Conclusions: Approximately 44.5% of the patients demonstrated the spontaneous resolution of vitreoretinal adhesion during the 6-month follow-up. The greater was the initial VA, the higher became the spontaneous separation rate, and eventually a better visual outcome.

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