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