title: Focal vitreomacular traction: a prospective study of the evolution to macular hole: the mathematical approach.
abstract: PURPORSE: To determine the associated balance of forces of the vitreofoveal interface in focal vitreomacular traction evolving to full-thickness macular hole (FTMH) and to link/explain the observed changes in the context of mathematical and physics models.
  
  
  METHODS
  This is a multicenter, prospective, and observational case series conducted at the Vitreoretinal Department of three different referral centers. Fellow eyes of patients with unilateral idiopathic FTMH were included. Eighty-nine patients were included in the analysis. The fellow normal eye of the study patients was imaged with spectral-domain optical coherence tomography. The main outcome measure was the optical-coherence-tomography-defined characteristics of the vitreofoveal interface and their analysis with mathematical and physics models at the end of follow-up period.
  
  
  RESULTS
  Of the included 89 patients (66 women and 23 men; mean age±SD, 68.5 years±9.8), 10 (11.2%) developed FTMH at the fellow eye at the end of the follow-up period. We observed two types of vitreofoveal attachment. A V-shaped (cord-like) configuration and a U-shaped configuration. The eyes with the V-shaped attachment demonstrated initial structural changes in the outer foveal layers and the eyes with the U-shaped attachment showed inner morphological changes.
  
  
  CONCLUSIONS
  We hypothesize that the type (V- or U-shaped) of the vitreofoveal attachment may affect the type and location of the initial structural change leading to the formation of FTMH from the stage of the focal vitreomacular traction.
authors.affiliation: Department of Ophthalmology, Henry Dunant Hospital, Athens, Greece.
authors.forename: G
authors.initials: G
authors.lastname: Theodossiadis
authors.affiliation: Moorfields Eye Hospital, London, UK.
authors.forename: P
authors.initials: P
authors.lastname: Petrou
authors.affiliation: 2nd Ophthalmology Department, University of Athens, 'ATTIKON' Hospital, Athens, Greece.
authors.forename: M
authors.initials: M
authors.lastname: Eleftheriadou
authors.affiliation: Department of Physics, Athens University, Athens, Greece.
authors.forename: A L
authors.initials: AL
authors.lastname: Moustakas
authors.affiliation: OMMA Ophthalmology Department, Athens, Greece.
authors.forename: I
authors.initials: I
authors.lastname: Datseris
authors.affiliation: 2nd Ophthalmology Department, University of Athens, 'ATTIKON' Hospital, Athens, Greece.
authors.forename: P
authors.initials: P
authors.lastname: Theodossiadis
mesh_terms: D000368:Aged; D058450:Endotamponade; D005260:Female; D005466:Fluorocarbons / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D016684:Prone Position; D011446:Prospective Studies; D012164:Retinal Diseases / Q000175:diagnosis*; D012167:Retinal Perforations / Q000145:classification / Q000175:diagnosis*; D000267:Tissue Adhesions; D041623:Tomography, Optical Coherence; D014821:Vitrectomy; D020255:Vitreous Detachment / Q000175:diagnosis*
chemical_list: D005466:Fluorocarbons; C042852:perflutren