Vitreomacular Traction and Outer Retinal Structural Changes

Abstract

In this case report we aimed to present the outer retinal structural changes secondary to vitreomacular traction (VMT). Outer retinal structural changes occurring secondary to VMT due to incomplete posterior vitreous detachment were described retrospectively with spectral-domain optical coherence tomography in 3 eyes of 3 patients. The patients ranged in age from 58 to 65 years and best corrected visual acuity in the 3 eyes was 4/10, 8/10, and 9/10. All of the patients were symptomatic and exhibited outer retinal microholes at the fovea extending from the retinal pigment epithelium to outer limiting membrane, with an overlying operculum on the detached posterior hyaloid membrane over the macula following spontaneous resolution of VMT. In the mean follow-up period of 32 months, the outer retinal microholes decreased in size but did not completely resolve. As demonstrated in these cases, VMT can cause small outer retinal layer defects without signs of full-thickness macular hole. These lesions can cause symptoms and affect visual function, and may be permanent structural changes.

Comparing six cases of external macular holes and literature review

“…The traction with superior vector force of the vitreous would form this triangular aspect that would remain in the case of a prior microhole closure that has already had traction in the past or evolve to a complete hole in the next stage of the PVD. If carefully observed, this characteristic of triangular aspect can be seen in other OCTs images with the same diagnosis (Figure 6; bottom; of Johnson's; Figure 1; Type5b; of Takezawa's; Figures 2 and 3; from Yıldırım) (31,32) and it may be an essential finding in the OCT for the differential diagnosis between solar retinopathy and external macular hole by vitreomacular traction, especially in cases where we have an external macular hole with no history of sun exposure.…”

Relationship Between Posterior Vitreous Detachment and Macular Dimensions in Myopic Eyes

“… 5 The usual slit-lamp examination with a +90.00 D lens fails to detect shallow PVDs. 5 The spectral-domain optical coherence tomography (SD-OCT) is commonly used 2 to image the structural relationship of the vitreomacular interface. 3 , 6 The SD-OCT method not only helps to qualitatively diagnose different stages of the disease but can also be used to quantify the PVD stages.…”

Does a Relationship Exist Between Posterior Vitreous Detachment, Macular Thickness and Foveal Avascular Zone Dimensions in Myopic Eyes?

“…[5] Currently, the spectral-domain optical coherence tomography (SD-OCT) is commonly used [2] to image the structural relationship of the vitreomacular interface [3,6]. The SD-OCT method not only helps to qualitatively diagnose different stages of disease but can also be used to quantify the PVD stages.…”

“…Liquefaction of the vitreous gel which is attached to the internal limiting membrane of the retina [1][2][3] or spontaneous posterior vitreous detachment (PVD) from the retina is considered to be a part of normal aging process [1,4]. The onset of PVD is usually reported around the fifth decade of life or later in normal [4].…”

“…The shallow PVD not only helps to predict the prognosis and also determines the indication for vitreoretinal surgery in many vitreoretinal conditions [5]. The usual slit lamp examination with a +90D lens fails to detect shallow PVDs [5] Currently, the spectral-domain optical coherence tomography (SD-OCT) is commonly used [2] to image the structural relationship of the vitreomacular interface [3,6]. The SD-OCT method not only helps to qualitatively diagnose different stages of disease but can also be used to quantify the PVD stages.…”