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Anatomical and functional espontaneous evolution of eyes with vitreomacular adhesion or traction

Session Details

Session Title: Quick Fire Free Paper Session 03

Session Date/Time: Sunday 29/09/2013 | 08:30-09:30

Paper Time: 09:05

Venue: Hall C (Level 1)

First Author: J.Figueira PORTUGAL

Co Author(s):    J. Cardoso   M. Soares   P. Fonseca   P. Magro     

Abstract Details

Purpose:

To evaluate anatomical and functional evolution of eyes with vitreomacular adhesion or traction (VMA or VMT) not submitted to treatment.

Setting:

CRIO / CHUC – Centro de Responsabilidade Integrado de Oftalmologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal AIBILI - Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal

Methods:

Retrospective study in eyes with VMA or VMT, which the diagnostic was made using spectral domain optical coherence tomography (SD-OCT), without other known retinal pathology, with a minimum follow-up of 6 months and not submitted to treatment. We evaluated the initial and final VA (visual acuity), symptoms, and follow-up time. All the SD-OCT performed during the follow up period were analyzed in order to identify structural alterations and their evolution.

Results:

We included 32 patients (38 eyes) with a mean age of 69.4 years (± 12.4), 22 women and 10 men. The median follow-up was 23.3 months (± 12.2). In 50% of patients the diagnostic of VMT or VMA was occasional (SD-OCT performed routinely or to clarify fellow eye pathology). 24 eyes (63%) had VMA and 14 (37%) had VMT. This group of eyes presented the following structural changes in initial SD-OCT: loss of foveal depression (2), neurosensory detachment (2), lamellar holes (3), cysts / macular edema (9). In eyes with AVM, 71% showed no changes in OCT during follow up, 25% and 4% had developed posterior vitreous detachment(PVD), epiretinal membrane (ERM). During the follow-up of eyes with TVM, 50% had no evolution in changes found in the initial SD-OCT, 22% had PVD, 14% had improvement in those changes and 14% worsened. The initial mean VA was 0.65 and at the final visit was 0.70 (p> 0.05).

Conclusions:

In our study we found anatomical and functional stability in most patients over a mean follow-up of 23.3 months, confirming that the AVM and TVM are clinical entities usually chronic and with a slow evolution. Most of those eyes can be structural (SD-OCT) and functional motorized without the necessity of early intervention. The option of surgery (vitrectomy) should be reserved for symptomatic cases and / or with clinical progression. New therapeutics, such as chemical vitreolysis can be interesting options to deal with this disease.

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