Clinical course of vitreomacular adhesion managed by initial observation.
OBJECTIVE
The purpose of the study was to investigate the clinical course of patients with idiopathic vitreomacular adhesion (VMA).


METHODS
A noncomparative case series of patients who had clinical symptoms and spectral-domain optical coherence tomography findings consistent with VMA. The VMA was graded based on the optical coherence tomography findings at initial and follow-up examinations. Grade 1 was incomplete cortical vitreous separation with attachment at the fovea, Grade 2 was the Grade 1 findings and any intraretinal cysts or clefts, and Grade 3 was the Grade 2 findings and the presence of subretinal fluid.


RESULTS
One hundred and six eyes of 81 patients were identified as having VMA by spectral-domain optical coherence tomography at 3 retina clinics. The mean age was 73 years and the mean time of follow-up was 23 months. Forty-three eyes (41%) had Grade 1 VMA, 56 eyes (52%) had Grade 2 VMA, and 7 eyes (7%) had Grade 3 VMA. By the last follow-up, spontaneous release of VMA occurred in 34 eyes (32%), and pars plana vitrectomy was performed in 5 eyes (4.7%). Mean best-corrected visual acuity was 0.269 logarithm of the minimum angle of resolution or 20/37 at baseline (range, 20/20-20/200) and logarithm of the minimum angle of resolution 0.251 or 20/35 at the last examination (range, 20/20-20/400).


CONCLUSIONS
In this selected patient cohort with mild symptoms, the clinical course of patients with VMA managed by initial observation was generally favorable.
*Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida; †Department of Ophthalmology, Dean McGee Eye Institute, University of Oklahoma School of Medicine, Oklahoma City, Oklahoma; and ‡Retina-Vitreous Associates Medical Group, Los Angeles, California.
Vishak J
VJ
John
Harry W
HW
Flynn
William E
WE
Smiddy
Adam
A
Carver
Robert
R
Leonard
Homayoun
H
Tabandeh
David S
DS
Boyer
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018450:Disease Progression; D005260:Female; D006801:Humans; D008268:Macular Degeneration / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012164:Retinal Diseases / Q000473:pathology* / Q000628:therapy; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D020255:Vitreous Detachment / Q000473:pathology* / Q000628:therapy