First Author: W.Fusi-Rubiano UK
Co Author(s): M. Awad I. Elaraoud R. Manjunath N. Narendran Y. Yang 0 0 0 0 0 0 0 0 0
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To determine the number of patients found to have Vitreo-Macular Adhesion (VMA) or Vitreo-Macular Traction (VMT) on Optical Coherence Tomography (OCT) over a finite period and to describe the spectrum of severity of foveal traction encountered.
Tertiary referral center for retinal imaging, mono-centric, retrospective study.
A study period of two consecutive months was randomly chosen. Patients scanned with Heidelberg OCT at least once were identified from the Heidelberg Eye Explorer database and included. First pass screen of all scans performed was performed to determine possible cases of VMA/VMT. Second pass confirmation of definite cases was done by one observer (YY) to enable determination of rate of diagnosis of new cases of VMA/VMT in two months. Severity of VMA/VMT were graded as follows: Posterior hyaloid not visible (Grade0), VMA only (Grade1), VMT with alteration of foveal surface (Grade2), VMT with elevation of fovea (Grade3), Presence of Cyst (Grade4), Presence of Sub retinal fluid (Grade5), partial break in retina (Grade6), full thickness hole (Grade7) and released VMT with operculum (Grade8).
Of 2223 patients and 4384 scan episodes in June and July 2013, 554 eyes of 278 patients were identified to have suspected VMA or VMT on first pass grading. On second pass grading only 358 eyes were found to have the following grades of VMA or VMT: Grade 0(n=144), Grade1(n=100), Grade2(n=28), Grade3(n=12), Grade4(n=47), Grade5(n=12), Grade6(n=4), Grade7(n=9), Grade8(n=2). Of these 214 eyes with Grades 1-8, 112 eyes had co-existing pathology in addition to VMA/VMT.
VMT is a common occurrence which can present at with varying degrees of tractional changes on OCT. Many cases of VMT can co-exist with other more severe macular conditions. Accurate definition and classification criteria are needed to ascertain the smaller subgroup of VMT patients who may benefit from pharmacological vitreolysis therapy.