Spontaneous resolution of vitreomacular traction demonstrated by spectral-domain optical coherence tomography.
OBJECTIVE
To evaluate the natural course of idiopathic vitreomacular traction (VMT) with spectral-domain optical coherence tomography (SDOCT) from the vitreomacular adhesion (VMA) stage to the spontaneous resolution of VMT.


METHODS
Prospective observational case series.


METHODS
We studied the natural course of idiopathic VMT in 46 eyes (46 patients), divided into those that proceeded to spontaneous VMT resolution (12 cases) and those that remained at the VMT stage (34 cases). All patients were examined with SDOCT at regular 3-month intervals. We recorded the vitreomacular angle of VMA nasally and temporally, the horizontal diameter of VMA, macular thickness, visual acuity, photoreceptor layer, and external limiting membrane.


RESULTS
In the 12 eyes that proceeded to spontaneous resolution, the vitreous adhesion angle had a mean increase of 38 degrees at VMT, compared to the angle at the VMA stage. In the 34 eyes that remained at the VMT stage, the mean angle of traction increased by only 1 degree throughout follow-up. In all 46 patients, the angle at the VMT stage was significantly associated with traction resolution (nasally P = .001, temporally P < .001). The likelihood of resolution was more than 99% lower for patients with a VMT diameter >400 μm compared with that of eyes with a VMT diameter <400 μm. Patients with broad-type VMT remained at the same stage, whereas patients with V-type VMT had 80% probability of resolution.


CONCLUSIONS
Spontaneous VMT resolution is negatively associated with the horizontal adhesion diameter. The strength of the traction exerted by the vitreous on the fovea seems to be positively related to the size of the vitreomacular angle.
2nd Department of Ophthalmology, Henry Dunant Hospital, Athens, Greece. Electronic address: theodossiadisg@ath.forthnet.gr.
George P
GP
Theodossiadis
2nd Department of Ophthalmology, Henry Dunant Hospital, Athens, Greece.
Vlassis G
VG
Grigoropoulos
2nd Department of Ophthalmology, University of Athens, Athens, Greece.
Sofia
S
Theodoropoulou
Ophthalmological Institute of Athens, Athens, Greece.
Ioannis
I
Datseris
2nd Department of Ophthalmology, University of Athens, Athens, Greece.
Panagiotis G
PG
Theodossiadis
D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012075:Remission, Spontaneous; D012164:Retinal Diseases / Q000175:diagnosis / Q000503:physiopathology*; D000267:Tissue Adhesions; D041623:Tomography, Optical Coherence / Q000379:methods*; D014143:Traction; D014792:Visual Acuity / Q000502:physiology; D014822:Vitreous Body / Q000503:physiopathology*; D020255:Vitreous Detachment / Q000175:diagnosis / Q000503:physiopathology*