Vitreomacular traction and exudative age-related macular degeneration.
Vitreomacular traction resulting from lacking, incomplete or anomalous posterior vitreous detachment is suspected to play a crucial role in the pathogenesis of different forms of age-related macular degeneration (AMD) along with the known mechanisms. It is probable that the fundamental pathomechanisms of AMD formation have already begun by the time tractional forces lead to a change for the worse. Vitreomacular traction alone is perhaps not able to induce AMD. It would seem sensible to consider vitreous changes when diagnosing and treating AMD patients because of the high coincidence of vitreomacular traction and choroidal neovascularization (CNV) and the often successful treatment of other diseases of the vitreoretinal interface by vitrectomy. The concept of the pathogenesis of AMD should therefore be extended to include the influence of the vitreous, especially where therapeutic concepts such as pharmacological vitreolysis and vitreous separation have been established as causative treatment of late forms of AMD.
Department of Ophthalmology, University Hospital Giessen and Marburg GmbH, Philipps University Marburg, Marburg, Germany. schulzes@med.uni-marburg.de
Stephan
S
Schulze
Steffen
S
Hoerle
Stefan
S
Mennel
Peter
P
Kroll
D000268:Adhesiveness; D005122:Exudates and Transudates; D006801:Humans; D008268:Macular Degeneration / Q000209:etiology* / Q000628:therapy; D012160:Retina / Q000473:pathology*; D000267:Tissue Adhesions / Q000150:complications*; D014822:Vitreous Body / Q000473:pathology* / Q000601:surgery