OCT-guided hyaloid release for vitreomacular traction syndrome.
OBJECTIVE
To evaluate the usefulness of OCT retinal mapping in determining the configuration of a vitreomacular adhesion and selecting a meridian for entry into the subhyaloid space in patients with vitreomacular traction syndrome.


METHODS
Six consecutive patients (6 eyes) with vitreomacular traction syndrome underwent vitrectomy with peeling of posterior hyaloid. Ocular coherence tomography (OCT) retinal mapping was performed preoperatively. Access to the subhyaloid space was made by creating an opening with a 25 gauge needle at a location where the detached posterior hyaloid membrane was farthest from the retinal surface. The location was selected based on six preoperative meridional OCT scans. The posterior hyaloid was then gently peeled off in a circular fashion around the fovea with a micropick. Visual acuity and foveal thicknesses were measured before the operation and 3 months afterwards.


RESULTS
After the operation, visual acuity improved and central macular thicknesses were reduced significantly in all six patients. The best corrected visual acuity improved from 0.4 to 0.75 with a mean increase by 3.5 lines on a Snellen chart 3 months after the operation. The mean foveal thickness was reduced from 406 micrometer to 241 micrometer. The restoration of foveal pit was observed in five patients. Neither intraoperative nor postoperative complications were observed during the follow up period.


CONCLUSIONS
An OCT retinal mapping program is a valuable diagnostic tool in understanding the configuration of vitreomacular adhesion and planning the surgical approach for operating on vitreomacular traction syndrome.
Chung
Eun Jee
EJ
Department of Ophthalmology, NHIC Ilsan Hospital, Gyounggi-do, Korea.
Lew
Young Ju
YJ
Lee
Hyo
H
Koh
Hyoung Jun
HJ
D000368:Aged; D005128:Eye Diseases / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012164:Retinal Diseases / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D013577:Syndrome; D000267:Tissue Adhesions / Q000209:etiology / Q000601:surgery; D041623:Tomography, Optical Coherence; D014792:Visual Acuity; D014821:Vitrectomy / Q000379:methods*; D014822:Vitreous Body / Q000473:pathology / Q000601:surgery*; D020255:Vitreous Detachment / Q000150:complications
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