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Anatomical configurations of vitreomacular traction syndrome: influence on clinical course and surgical outcomes

  • Retinal Disorders
  • Published:
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Abstract

Purpose

To develop a new classification system for vitreomacular traction (VMT) syndrome according to spectral-domain optical coherence tomography (SD-OCT) imaging and to investigate the clinical course of VMT patients.

Methods

This study included 68 eyes of 68 consecutive patients who were followed with observation or treated with vitrectomy for idiopathic VMT. Eyes were classified into one of three groups according to SD-OCT findings: group A (foveal pseudocyst, which was defined as the formation of cystoid cavity located in the inner part of the central fovea along with foveal thickening), group B (parafoveal retinoschisis, which was defined as intraretinal cysts or clefts along with no apparent foveal thickening), and group C (outer retinal dehiscence at the fovea, which is sometimes accompanied by foveal thinning). The minimum required follow-up period was 1 year. Clinical course and anatomical and functional outcomes were compared among the groups.

Results

Twenty-seven eyes (39.7%) were included in group A, 22 eyes (32.4%) were included in group B, and 19 eyes (27.9%) were included in group C. Among the 24 eyes that were managed by observation, a significantly larger percentage of patients in group A (6/10 [60%]) exhibited more spontaneous resolution of VMT compared with those in groups B (9.1%) or C (0%) (P = 0.010). In the 44 eyes that were managed with vitrectomy, a significantly larger percentage of patients in group C (4/16 [25%]) experienced subsequent full-thickness macular hole development following vitrectomy compared with those in groups B (0%) or C (0%) (P = 0.014). The percentage of patients with photoreceptor inner segment/outer segment disruption was significantly reduced in group A after vitrectomy, with group C exhibiting the lowest recovery rate. Postoperatively, group A experienced a significantly better visual outcome than group C (P = 0.021).

Conclusions

A novel configuration system offering insight into the clinical course of VMT is proposed. According to this system, anatomical and functional outcomes were favorable in group A and worse in group C.

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Funding

This work was supported by a research grant from Jeju National University Hospital in 2016.

Author information

Authors and Affiliations

  1. Department of Ophthalmology, Jeju National University School of Medicine, Jeju National University Hospital, Jeju, South Korea

    Eun Kyoung Lee, Sang-Yoon Lee & Jong Young Lee

  2. Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, South Korea

    Eun Kyoung Lee & Hyeong Gon Yu

  3. SNU Seoul Eye Clinic, Seoul, South Korea

    Jang Won Heo

  4. Department of Ophthalmology, Chung-Ang University Hospital, #102, Heukseok-ro, Dongjak-gu, Seoul, 06973, Republic of Korea

    Hum Chung

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  1. Eun Kyoung Lee
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  2. Sang-Yoon Lee
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  3. Jong Young Lee
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  4. Jang Won Heo
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  5. Hyeong Gon Yu
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  6. Hum Chung
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Corresponding author

Correspondence to Hum Chung.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Lee, E.K., Lee, SY., Lee, J.Y. et al. Anatomical configurations of vitreomacular traction syndrome: influence on clinical course and surgical outcomes. Graefes Arch Clin Exp Ophthalmol 257, 1631–1639 (2019). https://doi.org/10.1007/s00417-019-04352-9

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  • DOI: https://doi.org/10.1007/s00417-019-04352-9

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