title: Vitreomacular adhesion in active and end-stage age-related macular degeneration.
abstract: OBJECTIVE
  To evaluate vitreomacular relations in different stages of age-related macular degeneration (AMD) without the influence of genetics and environmental factors.
  
  
  METHODS
  Retrospective, observational case series.
  
  
  METHODS
  This was a multicenter study consisting of 29 previously untreated subjects with active exudative (wet) AMD in one eye and active nonexudative (dry) AMD in the fellow eye who were compared with 10 previously untreated subjects with end-stage geographic atrophy in one eye and an end-stage fibrotic (disciform) scar in the fellow eye. All subjects were studied with ultrasonography to identify the presence of posterior vitreous detachment (PVD) and by optical coherence tomography to detect vitreomacular adhesion (VMA).
  
  
  RESULTS
  The incidence of PVD in eyes with nonexudative AMD was 20 (69%) of 29, compared with 6 (21%) of 29 with active exudative AMD (P = .002). VMA was present in 11 (38%) of 29 of eyes with exudative AMD and in only 3 (10%) of 29 eyes with nonexudative AMD (P = .008). The incidence of PVD in geographic atrophy was 7 (70%) of 10, compared with 4 (40%) of 10 with disciform scar (P = .44). VMA was present in 2 (20%) of 10 eyes with disciform scars and in 0 (0%) of 10 eyes with geographic atrophy (P = .48).
  
  
  CONCLUSIONS
  PVD may protect against exudative AMD, whereas VMA may promote exudative AMD. This phenomenon is not evident in end-stage disease because of an increased incidence of PVD and a decreased incidence of VMA in eyes with disciform scars. Genetic and environmental factors do not seem to influence these observations.
authors.affiliation: VMR Institute, Huntington Beach, California, USA.
authors.forename: Craig D
authors.initials: CD
authors.lastname: Robison
authors.forename: Ilse
authors.initials: I
authors.lastname: Krebs
authors.forename: Susanne
authors.initials: S
authors.lastname: Binder
authors.forename: Irene A
authors.initials: IA
authors.lastname: Barbazetto
authors.forename: Athanasios I
authors.initials: AI
authors.lastname: Kotsolis
authors.forename: Lawrence A
authors.initials: LA
authors.lastname: Yannuzzi
authors.forename: Alfredo A
authors.initials: AA
authors.lastname: Sadun
authors.forename: Jerry
authors.initials: J
authors.lastname: Sebag