Vitreomacular adhesion and the defect in posterior vitreous cortex visualized by triamcinolone-assisted vitrectomy.
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.
Doi
Norihito
N
Department of Ophthalmology, Faculty of Medicine, Kagoshima University Graduate School of Medicine and Dental Sciences, Kagoshima, Japan.
Uemura
Akinori
A
Nakao
Kumiko
K
Sakamoto
Taiji
T
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*
D005938:Glucocorticoids; D014222:Triamcinolone Acetonide