title: Vitreomacular adhesion and the defect in posterior vitreous cortex visualized by triamcinolone-assisted vitrectomy.
abstract: OBJECTIVE
  To study the vitreomacular adhesion and the contractile force of posterior hyaloid, which are shown in triamcinolone acetonide (TA)-assisted pars plana vitrectomy (PPV).
  
  
  METHODS
  Interventional case series.
  
  
  METHODS
  Twenty-eight eyes with diabetic macular edema (DME) without posterior vitreous detachment (PVD) received TA-assisted PPV. Surgical PVD was performed by an aspiration of vitrectomy probe, and the dynamic changes of posterior vitreous cortex and residual vitreous cortex were evaluated.
  
  
  RESULTS
  A premacular defect was formed in the detached posterior vitreous cortex during surgical PVD in 27 of 28 eyes. Immediately thereafter, the small defect expanded into a large hole in the detached posterior vitreous cortex in all cases. A residual vitreous cortex was left on the macula in 22 eyes.
  
  
  CONCLUSIONS
  These observations demonstrate a firm vitreoretinal adhesion in the central macula and suggest that the enlargement of the defect of posterior vitreous cortex may be extrusion of vitreous out through the premacular dehiscence into the preretinal space, or a tangentially contractile force may exist in the posterior vitreous cortex. Both macular adhesion and the traction of vitreous cortex might contribute to the pathogenesis of DME and other vitreomacular disease.
authors.affiliation: Department of Ophthalmology, Faculty of Medicine, Kagoshima University Graduate School of Medicine and Dental Sciences, Kagoshima, Japan.
authors.forename: Norihito
authors.initials: N
authors.lastname: Doi
authors.forename: Akinori
authors.initials: A
authors.lastname: Uemura
authors.forename: Kumiko
authors.initials: K
authors.lastname: Nakao
authors.forename: Taiji
authors.initials: T
authors.lastname: Sakamoto
mesh_terms: D003930:Diabetic Retinopathy / Q000601:surgery; D005128:Eye Diseases / Q000175:diagnosis*; D005260:Female; D005938:Glucocorticoids; D006801:Humans; D008269:Macular Edema / Q000601:surgery; D008297:Male; D012160:Retina / Q000378:metabolism*; D000267:Tissue Adhesions / Q000175:diagnosis*; D014222:Triamcinolone Acetonide; D014821:Vitrectomy; D014822:Vitreous Body / Q000378:metabolism / Q000473:pathology*
chemical_list: D005938:Glucocorticoids; D014222:Triamcinolone Acetonide