Vitreo-macular Traction and Age-Related Macular Degeneration
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In this chapter the relationship between the posterior vitreous and the macula in patients with age-related macular degeneration (AMD) is described. While in earlier years biomicroscopy and ultrasound examinations were used to determine the status of the vitreous in elderly patients, modern optical coherence tomography (OCT) has tremendously changed our insight about the relationship between the vitreous and the macular also in patients suffering from AMD. Here we give an overview of our findings and those from others about recent knowledge of the VR interface in AMD and it’s possible influence on exudation, development of neovascularisation and disease progression. With high-definition OCT , we were able to prove in several prospective studies that vitreo-macular adhesion indeed occurs more often in wet than in dry AMD and that the area of highest traction is usually the area where the neovascular process has its origin. Whether vitreo-macular adhesion in exudative AMD is causative for disease development or occurs as a consequence and triggers further progression remains to be seen.
KeywordsOptical Coherence Tomography Macular Hole Posterior Vitreous Detachment Retinal Angiomatous Proliferation Posterior Hyaloid
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