title: [Dynamic vitreomacular traction].
abstract: OBJECTIVE
  To describe clinical findings in patient with dynamic changes of vitreomacular interface and retina. To provide summary of findings about mechanism of accommodation and its potential impact on vitreous and retina.
  
  
  METHODS
  In 57 year old patient we performed comprehensive ophtalmological examination including spectral domain optical coherent tomography (SD-OCT). We observed the impact of accommodative effort, head-downward position, combination of accommodative effort and head-downward position and influence of light reflex on vitreomacular interface and retina and change of minimal foveal thickness.
  
  
  RESULTS
  On SD-OCT we could observe vitreofoveal adhesion on both eyes. During accommodative effort in combination with head-downward position we could observe symptomatic dynamic vitreomacular traction with temporary elevation of minimal foveal thickness. We could not observe impact of only head-downward posture, reading with spectacle correction of presbyopia or light reflex on change of vitreomacular interface or retina.
  
  
  CONCLUSIONS
  We should suspect dynamic changes of vitreomacular interface and retina when we see fluctuating impairment of central visual acuity particularly when it is in connection with accommodation and head-downward posture.Key words: accommodation, head-downward position, vitreomacular interface, SD-OCT.
authors.forename: P
authors.initials: P
authors.lastname: Cigánek
authors.forename: L
authors.initials: L
authors.lastname: Matoušková
authors.forename: B
authors.initials: B
authors.lastname: Kousal
mesh_terms: D003937:Diagnosis, Differential; D018475:Head-Down Tilt; D006801:Humans; D008266:Macula Lutea / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012164:Retinal Diseases / Q000175:diagnosis* / Q000503:physiopathology; D000267:Tissue Adhesions / Q000175:diagnosis* / Q000503:physiopathology; D041623:Tomography, Optical Coherence; D014792:Visual Acuity; D014822:Vitreous Body / Q000473:pathology*