title: Vitreous attachment in age-related macular degeneration, diabetic macular edema, and retinal vein occlusion: a systematic review and metaanalysis.
abstract: OBJECTIVE
  To determine if there is an association of vitreous attachment and wet age-related macular degeneration (AMD), diabetic macular edema, and retinal vein occlusion.
  
  
  METHODS
  Systematic review and metaanalysis.
  
  
  RESULTS
  Sixteen of 1,025 articles were eligible. In wet AMD, the prevalence of vitreomacular adhesion and posterior vitreous detachment was 23% (654 eyes) and 41% (251), respectively. Vitreomacular adhesion prevalence was 2.15 times that of controls (95% confidence interval, 1.34-3.48; p = 0.002) and 2.54 times that of dry AMD (confidence interval, 0.88-7.36; p 0.09); posterior vitreous detachment prevalence was lower than controls (relative risk 0.77; confidence interval, 0.64-0.93; p = 0.007) and dry AMD (0.56; confidence interval, 0.27-1.14; p = 0.11). It was not possible to determine the prevalence of vitreous attachment in diabetic macular edema, but vitreomacular traction was present in 29% of 188 surgical cases. The prevalence of posterior vitreous detachment in eyes with central and branch retinal vein occlusion was 30% (56 eyes) and 31% (71 eyes), respectively, versus 25% (64 eyes) in controls.
  
  
  CONCLUSIONS
  Observational studies of sufficient quality indicate that eyes with wet AMD have double the expected prevalence of vitreomacular adhesion and are less likely to have a posterior vitreous detachment. More controlled studies of diabetic macular edema and retinal vein occlusion are needed.
authors.affiliation: Guthrie Clinic, King's College Hospital, London, United Kingdom. t.jackson1@nhs.net
authors.forename: Timothy L
authors.initials: TL
authors.lastname: Jackson
authors.forename: Elena
authors.initials: E
authors.lastname: Nicod
authors.forename: Aris
authors.initials: A
authors.lastname: Angelis
authors.forename: Federico
authors.initials: F
authors.lastname: Grimaccia
authors.forename: A Toby
authors.initials: AT
authors.lastname: Prevost
authors.forename: Andrew R H
authors.initials: AR
authors.lastname: Simpson
authors.forename: Panos
authors.initials: P
authors.lastname: Kanavos
mesh_terms: D003930:Diabetic Retinopathy / Q000453:epidemiology*; D006801:Humans; D008269:Macular Edema / Q000453:epidemiology*; D015995:Prevalence; D012170:Retinal Vein Occlusion / Q000453:epidemiology*; D000267:Tissue Adhesions / Q000453:epidemiology; D020255:Vitreous Detachment / Q000453:epidemiology*; D057135:Wet Macular Degeneration / Q000453:epidemiology*