Posterior vitreomacular adhesion: a potential risk factor for exudative age-related macular degeneration?
OBJECTIVE
To compare the state of the posterior vitreous in exudative age-related macular degeneration (AMD) with eyes with nonexudative AMD and controls.


METHODS
Prospective, observational case series.


METHODS
B-scan ultrasonography and optical coherence tomography (OCT) were performed in 163 eyes from 82 subjects older than 55 years, 50 eyes with exudative AMD, 57 with nonexudative AMD, and 56 control eyes. Main outcome measures were the number of eyes with complete posterior vitreous detachment (PVD) by ultrasound and the number of eyes with central vitreomacular adhesion by OCT.


RESULTS
By ultrasonography, 17 (34.0%) of 50 eyes with exudative AMD had PVD as compared with 41 (71.9%) of 57 eyes with nonexudative AMD (P = .00002) and 34 (60.7%) of 56 controls (P = .017). OCT detected persistent central vitreoretinal adhesion surrounded by a detached posterior vitreous cortex in 18 (36%) of 50 eyes with exudative AMD, significantly higher than in nonexudative AMD (4/57 [7%]; P < .0001) and in controls (6/56 [10%]; P = .002).


CONCLUSIONS
Persistent attachment of the posterior vitreous cortex to the macula may be another risk factor for the development of exudative AMD via vitreoretinal traction inducing chronic low-grade inflammation, by maintaining macular exposure to cytokines or free radicals in the vitreous gel, or by interfering in transvitreous oxygenation and nutrition of the macula. Inducing PVD may provide prophylactic benefit against exudative AMD.
Krebs
Ilse
I
Ludwig Boltzmann Institute for Retinology and Biomicroscopic Laser Surgery, Vienna, Austria. Ilse.Krebs@wienkav.at
Brannath
Werner
W
Glittenberg
Carl
C
Zeiler
Florian
F
Sebag
Jerry
J
Binder
Susanne
S
D000368:Aged; D000369:Aged, 80 and over; D005122:Exudates and Transudates; D005128:Eye Diseases / Q000150:complications* / Q000175:diagnosis; D005260:Female; D006801:Humans; D008266:Macula Lutea / Q000473:pathology*; D008268:Macular Degeneration / Q000175:diagnosis / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D000267:Tissue Adhesions / Q000150:complications / Q000175:diagnosis; D041623:Tomography, Optical Coherence; D014463:Ultrasonography; D014822:Vitreous Body / Q000000981:diagnostic imaging / Q000473:pathology*; D020255:Vitreous Detachment / Q000150:complications* / Q000000981:diagnostic imaging