Spontaneous resolution of vitreomacular traction: a case series

Abstract

Three patients had unilateral vitreomacular traction (VMT) syndrome and the diagnosis was confirmed by spectral domain‐type optical coherence tomography (OCT). All patients were female aged 51, 55 and 62 years. All denied surgical intervention. In one patient, rapid spontaneous resolution of the vitreomacular traction with a complete posterior vitreous detachment (PVD) and a normal foveal contour was achieved within 15 days. In the remaining two cases a complete PVD could be detected as late as seven months after the initial presentation. In one, though the vitreomacular adhesion released spontaneously, there was a minimal residual epiretinal membrane. In all three eyes, visual acuity was considerably improved. Spontaneous, uneventful resolution has been rarely reported in the natural course of VMT but several recent studies with the aid of OCT have shown that spontaneous resolution might be more common than previously known. In light of our cases, we believe that there is still room to search for OCT clues in eyes with VMT to predict eyes with higher likelihood of spontaneous resolution, thereby avoiding unnecessary pharmacologic and/or surgical intervention.

Electronic Medical Record Database Study of Vitrectomy and Observation for Vitreomacular Traction

“…[1][2][3][4][5][6][7][8][9] A recent synthesis of the literature on the safety and effectiveness of PPV for VMT revealed that only one-third of eyes gained two or more Snellen lines. 10 Equally, observation may have disadvantages, with a natural history study reporting that only 11% of eyes showed spontaneous resolution over a mean follow-up of 5 years, whereas 64% of eyes lost at least 2 Snellen lines over this timeframe.…”

Incidence of Pseudophakic Cystoid Macular Oedema Post-Cataract Surgery in Illawarra Shoalhaven Local Health District, Australia

“…Given the high rates of PCMO generally in the DM populations, it is fair to conclude pharmaceutical management is suboptimal, and future efforts should be directed towards de-DOI: 10.1159/000521053 veloping more evidence-based medical therapies. For patients with VMT and DM before undergoing cataract surgery, it may be beneficial to undergo a vitrectomy to reduce the chances of developing post-operative PCMO or delaying cataract surgery for spontaneous resolution of VMT which has been observed in 11% of cases within 15 months [46,47].…”

Pneumatic Vitreolysis Versus Pars Plana Vitrectomy in Focal Symptomatic Vitreomacular Traction Syndrome

“…4 Newer studies, however, have suggested that spontaneous resolution might be more common than previously thought. 5,6 Vitreomacular traction is subclassified on the basis diameter of vitreous adhesion to the macular surface, with an attachment of #1,500 mm or .1,500 mm defined as focal or broad VMT, respectively. 1 Treatment options for focal symptomatic VMT include pharmacological vitreolysis, pneumatic vitreolysis (PV), and pars plana vitrectomy (PPV).…”

“…4 Newer studies, however, have suggested that spontaneous resolution might be more common than previously thought. 5,6…”