Efficacy and Safety of Treatment Options for Vitreomacular Traction

Yu, Gina; Duguay, James; Marra, Kyle V.; Gautam, Shiva; Guern, Guillaume Le; Begum, Shimul; Sharifzadeh, Arya; Arroyo, Jorge G.

doi:10.1097/iae.0000000000000909

Cited by 32 publications

(43 citation statements)

References 39 publications

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“…In a meta-analysis, pneumatic vitreolysis approached similar release rates of pars plana vitrectomy and was more effective than ocriplasmin by day 28. 95 Complications of this procedure are typically related to PVD formation and include retinal tear, retinal detachment, epiretinal membrane, and lamellar or macular hole formation. 94,95 It is essential that clinical personnel be familiar with the symptoms of PVD and retinal detachment and that they recognize the need for urgent ophthalmologic evaluation of symptomatic patients.…”

Section: I++mentioning

confidence: 99%

“…95 Complications of this procedure are typically related to PVD formation and include retinal tear, retinal detachment, epiretinal membrane, and lamellar or macular hole formation. 94,95 It is essential that clinical personnel be familiar with the symptoms of PVD and retinal detachment and that they recognize the need for urgent ophthalmologic evaluation of symptomatic patients. 14 vitrectomy is an option if symptomatic floaters are still bothersome after several months.…”

Section: I++mentioning

confidence: 99%

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Posterior Vitreous Detachment, Retinal Breaks, and Lattice Degeneration Preferred Practice Pattern®

et al. 2020

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Section: I++mentioning

confidence: 99%

Section: I++mentioning

confidence: 99%

Posterior Vitreous Detachment, Retinal Breaks, and Lattice Degeneration Preferred Practice Pattern®

et al. 2020

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“…A total of 91 eyes from 90 patients with sVMA were included from one nonrandomized controlled study, six uncontrolled studies and two individual case reports (Table 1) (Chan et al 1995;Costa et al 2001;Jorge et al 2006;Mori et al 2007;Gupta & McHugh 2011;Chen et al 2012;Rodrigues et al 2013;Day et al 2016;Yu et al 2016). A total of 91 eyes from 90 patients with sVMA were included from one nonrandomized controlled study, six uncontrolled studies and two individual case reports (Table 1) (Chan et al 1995;Costa et al 2001;Jorge et al 2006;Mori et al 2007;Gupta & McHugh 2011;Chen et al 2012;Rodrigues et al 2013;Day et al 2016;Yu et al 2016).…”

Section: Resultsmentioning

confidence: 99%

“…Of 106 articles, 106 abstracts were assessed as potentially eligible, from which nine articles were deemed eligible after full-text review. A total of 91 eyes from 90 patients with sVMA were included from one nonrandomized controlled study, six uncontrolled studies and two individual case reports (Table 1) (Chan et al 1995;Costa et al 2001;Jorge et al 2006;Mori et al 2007;Gupta & McHugh 2011;Chen et al 2012;Rodrigues et al 2013;Day et al 2016;Yu et al 2016). Additional, anonymous participant-level VA data were obtained from one study author as this information was not available in his report, in accordance with PRISMA guidance (Rodrigues et al 2013).…”

Section: Resultsmentioning

confidence: 99%

Intravitreal gas for symptomatic vitreomacular adhesion: a synthesis of the literature

Neffendorf

Simpson

Steel

et al. 2017

Acta Ophthalmologica

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Symptomatic vitreomacular adhesion (sVMA) is defined as visual loss secondary to foveal damage from vitreomacular traction (VMT) and includes isolated VMT, impending macular hole (MH), and full-thickness MH with persisting vitreous attachment. Management options include pars plana vitrectomy (PPV), intravitreal ocriplasmin, intravitreal gas injection or observation. This synthesis of the literature aimed to assess the safety and efficacy of intravitreal gas for sVMA. Articles describing patients with VMT or MH treated with intravitreal expansile gas were selected by systematic literature review using MEDLINE, EMBASE, and the Cochrane Database of Controlled Trials (CENTRAL) up to September 2016. The main outcomes at 1 month and final review were logarithm of the minimum angle of resolution (logMAR) visual acuity (VA), anatomical success (absence of both VMT and MH, without PPV) and adverse events (AEs). The intended comparator was observation. Nine of 106 identified articles were eligible, and none were randomized controlled trials. The mean VA of 91 eyes improved from 0.55 (Snellen equivalent 6/21) to 0.48 (6/18) logMAR at 1 month and to 0.35 (6/13) logMAR at final review. The mean VA at final review, prior to a vitrectomy, was 0.42 (6/16). Anatomic success was 48% at 1 month and 57% at final review. The reported AEs comprised retinal detachment in two highly myopic eyes. Intravitreal gas injection can relieve sVMA. Larger controlled studies are needed to determine safety and efficacy relative to observation, ocriplasmin, or vitrectomy.

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“…Cases of retinal detachment and development of MH were also reported with ocriplasmin. [8,9,21] Pneumatic Vitreolysis (PVL)…”

Section: Ocriplasminmentioning

confidence: 99%

Idiopathic macular holes – A review of current management strategies

Sela¹,

Hadayer²,

Zahavi³

2019

cleverjournal

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Description of the Condition Macular holes (MHs) are retinal defects which involve the center of the anatomical fovea. [1,2] Severity may range from asymptomatic incidentally discovered MHs, to advanced vision-threatening ones. [2,3] MHs are often described according to the extent of retinal layers involvement. Full-thickness MHs (FTMHs) encompass all the layers of the retina from the internal limiting membrane (ILM) to the retinal pigmented epithelium (RPE) [Figure 1]. [2] Partialthickness MHs, also termed lamellar holes, involve only the inner retinal layers, while the photoreceptors layer may remain intact [Figure 2]. [2,3] Although the majority of cases are idiopathic (>85%), MHs may also be secondary to various conditions, among the most common of which are high myopia and ocular trauma. [2,4,5] Kumawat et al. described in detail other infrequent causes of secondary MHs. [5] Epidemiology The reported prevalence of idiopathic MHs (IMHs) in the general population ranges between 0.02% and 0.33%. [1,4] IMHs are more common in women (approximately 70% of cases) and usually appear in the 6 th and 7 th decades of life. [1,4,6] For patients with an idiopathic FTMH in one eye, the risk for developing an MH in the fellow eye is 10-20%. [1,7] Pathophysiology IMHs are the sequelae of vitreomacular adhesion (VMA) and traction (VMT). [2] The vitreous is a clear gel-like structure enveloped by a hyaloid membrane (the vitreous cortex), the posterior part of which is attached to the ILM of the retina. With aging, the vitreous body liquefies, shrinks, and gradually detaches from the retina, starting at the posterior pole. Physiologically, the vitreous will continue to detach from the retina and eventually remain firmly attached to the retina only at the vitreous base, straddling the ora serrata. In most cases, this process results in no retinal damage. [2,8,9] However, incomplete or abnormal detachment may result in pathologic VMA and VMT, which can distort the foveal contour and result in MH formation [Figure 3]. [8] The traction forces affect the foveola and might impair central vision, causing distorted vision or decreased visual acuity (VA). [2,5,10]

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Efficacy and Safety of Treatment Options for Vitreomacular Traction

Abstract: Our analysis found that PV releases VMT in most patients and suggest that PV may be as effective or superior to nonsurgical options for VMTr at Day 28 with a similar risk profile.

Cited by 32 publications

References 39 publications

Posterior Vitreous Detachment, Retinal Breaks, and Lattice Degeneration Preferred Practice Pattern®

Posterior Vitreous Detachment, Retinal Breaks, and Lattice Degeneration Preferred Practice Pattern®

Intravitreal gas for symptomatic vitreomacular adhesion: a synthesis of the literature

Idiopathic macular holes – A review of current management strategies

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