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Vitreo-macular traction correlation of morphology with post-operative visual changes

Session Details

Session Title: Vitreoretinal Surgery II

Session Date/Time: Thursday 26/09/2013 | 14:30-16:00

Paper Time: 14:30

Venue: Hall 3 (Level 0)

First Author: M.Uparkar INDIA

Co Author(s):                  

Abstract Details

Purpose:

To analyze the visual outcomes of vitreomacular traction after vitrectomy and correlate this with the pre-operative morphology.

Setting:

Retrospective study in patients with vitreomacular traction and visual symptoms operated at a single tertiary eye care center in Mumbai city

Methods:

Patients with Vitreomacular traction (VMT) due to diabetic macular edema or central retinal vein occlusion and operated between 2012 and 2013 were identified .Routine pre-operative assessment for BCVA ( Snellen) , Goldmann applanation tension , refraction and dilated fundus evaluation was followed by assessment of VMT by OCT ( SD OCT 2000). ( Microincision vitrectomy surgery (MIVS) was done by single surgeon using standard 23G instruments (Alcon) .Post-operative visual acuity and VMT assessment using OCT was done at 4 weeks and 16 weeks after surgery.

Results:

Two types of VMT were noted . Those with broad attachment along the retinal surface and at fovea and those with focal tenting of the fovea with localized or point attachment . 23 eyes of 23 patients were studied . Median age at diagnosis was 56 years with 72 percent being male. Diabetic maculopathy was the most common etiology in 64%( 15/23) eyes. Median duration of symptoms was 4 months. Median pre-operative BCVA was 6/18 with focal VMT in 11Eyes and broad VMT ( Tangential ) in 12 Eyes. The final BCVA at 16 weeks was significantly better than the presenting BCVA ( p<0.05) . In eyes with DME and VMT the visual acuity showed significantly better outcome after surgery mean change of 3 lines on Snellen Morphological restoration of retinal and foveal architecture was seen in 19 eyes . Eyes with non-diabetic VMT showed morphological resolution however the post surgical BCVA was not statistically significantly better than pre-op BCVA(p<0.05). DME patients were more more likely to have focal VMT (OR 3.1 95%CI 2.2-5.7)

Conclusions:

In this series , DME patients were more likely to have a focal vitreomacular traction complex which shows significant VA improvements after vitrectomy . Broad vitreomacular traction was seen more often in central vein occlusion and showed anatomical resolution without significant visual improvement post vitrectomy.

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