title: Clinical Course of Vitreomacular Traction Managed Initially by Observation.
abstract: OBJECTIVE
  To investigate the clinical course and outcomes of patients with vitreomacular traction (VMT) managed initially by observation.
  
  
  METHODS
  This noncomparative case series included patients with a diagnosis of VMT based on clinical symptoms and findings on spectral-domain optical coherence tomography (SD-OCT) between 2005 and 2014. VMT was documented using a standardized grading system based on the degree of distortion of the foveal contour. Data were collected at five retina clinics using standardized collection forms. Visual acuity, changes in SD-OCT findings, and timing of the release of VMT as seen on SD-OCT were recorded.
  
  
  RESULTS
  The study included 230 eyes of 185 patients. Mean age was 72.5 years, and mean follow-up was 32 months. At baseline, VMT grading was grade 1 in 92 eyes (40%), grade 2 in 118 eyes (51.3%), and grade 3 in 20 eyes (8.7%). By last follow-up, spontaneous release of VMT occurred in 73 eyes (31.7%). Spontaneous release of VMT occurred at a mean of 18 months (median: 10.9 months) after initial visit. Mean logMAR best corrected visual acuity (BCVA) was 0.28 (20/55) (range: 20/20 to 20/400) at baseline and 0.25 (20/51) (range: 20/20 to 20/400) at last follow-up. Pars plana vitrectomy was performed in 10 eyes (4.1%) for macular hole (six eyes) and increased VMT (four eyes); BCVA was at least 20/40 in eight of the 10 eyes at last follow-up.
  
  
  CONCLUSIONS
  Patients with VMT generally had a favorable clinical course when managed initially by observation. Spontaneous release of VMT occurred in approximately one-third of patients. At last follow-up, pars plana vitrectomy was performed in fewer than 5% of patients.
authors.forename: Jonathan H
authors.initials: JH
authors.lastname: Tzu
authors.forename: Vishak J
authors.initials: VJ
authors.lastname: John
authors.forename: Harry W
authors.initials: HW
authors.lastname: Flynn
authors.forename: William E
authors.initials: WE
authors.lastname: Smiddy
authors.forename: Jared R
authors.initials: JR
authors.lastname: Jackson
authors.forename: Blake A
authors.initials: BA
authors.lastname: Isernhagen
authors.forename: Adam
authors.initials: A
authors.lastname: Carver
authors.forename: Robert
authors.initials: R
authors.lastname: Leonard
authors.forename: Homayoun
authors.initials: H
authors.lastname: Tabandeh
authors.forename: David S
authors.initials: DS
authors.lastname: Boyer
authors.forename: Maria H
authors.initials: MH
authors.lastname: Berrocal
authors.forename: Mihoko
authors.initials: M
authors.lastname: Suzuki
authors.forename: K Bailey
authors.initials: KB
authors.lastname: Freund
authors.forename: Jeffrey G
authors.initials: JG
authors.lastname: Gross
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019370:Observation; D012164:Retinal Diseases / Q000175:diagnosis* / Q000503:physiopathology; D000267:Tissue Adhesions; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy; D014822:Vitreous Body / Q000473:pathology*; D020255:Vitreous Detachment / Q000175:diagnosis* / Q000503:physiopathology