Prevalence of vitreomacular adhesion: an optical coherence tomography analysis in the retina clinic setting.
OBJECTIVE
The aims of this study were to determine the prevalence of vitreomacular adhesion (VMA) in a random sample of clinical patients at three US retina clinics and to assess comorbid retinal conditions, ocular diseases, prior treatment history, and other medical histories.


METHODS
This observational, retrospective cohort study was based on patients from the Doheny Eye Centers, Duke Eye Center, and Tufts Medical Center who received a bilateral spectral domain optical coherence tomography (SD-OCT) scan (one scan/eye) for clinical evaluation with available medical records. The study had three phases: 1) collection of retrospective patient data; 2) review of OCT scans at a reading center to assess VMA and associated conditions; and 3) analyses and reporting of data on the prevalence of VMA, patient demographics, and comorbid conditions. Data were obtained from electronic health records and OCT grading forms. Outcome measures from bilateral SD-OCT scans and medical records included OCT evaluation of VMA and retinal comorbid conditions.


RESULTS
In 719 patients with 1,483 reviewable OCT scans, the prevalence of VMA was estimated at 14.74% (90% CI, 12.58%-16.92%). The prevalence of unilateral VMA was estimated at 12.39%, while bilateral VMA was 2.36%. In patients with VMA, 34 out of 123 eyes with VMA (27.64%) also had fovea deformed by vitreomacular traction. Macular hole (MH) was significantly more prevalent in VMA-diagnosed eyes versus non-VMA-diagnosed eyes (6.5% versus 1.9%; P=0.02). There was a significantly higher incidence of full-thickness MH (P=0.008), operculum/flaps (P<0.0001), and lamellar or pseudo-holes (P=0.048) in VMA-diagnosed versus non-VMA-diagnosed eyes. Age, MH as a comorbid condition, full-thickness MH, lamellar or pseudo-holes, and operculum were predictive of a VMA diagnosis.


CONCLUSIONS
The prevalence of VMA was estimated at 14.74% in a random sample of patients from three retina clinics. VMA diagnosis can be predicted by factors, including age, MH as a comorbid condition, and lamellar or pseudo-holes.
Department of Ophthalmology, New England Eye Center, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA.
Elias
E
Reichel
Duke Eye Center, Duke Reading Center, Durham, NC, USA.
Glenn J
GJ
Jaffe
Department of Ophthalmology, Doheny Eye Centers, University of California, Los Angeles, CA, USA.
Srinivas R
SR
Sadda
Duke Eye Center, Duke Reading Center, Durham, NC, USA.
Stefanie
S
Schuman
Department of Ophthalmology, Doheny Eye Centers, University of California, Los Angeles, CA, USA.
Amir H
AH
Hariri
Department of Ophthalmology, New England Eye Center, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA.
Keegan
K
Skidmore
Department of Ophthalmology, New England Eye Center, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA.
Jake
J
Duker
OCT; VMA; comorbid conditions; lamellar or pseudo-holes; macular hole; operculum/flaps; vitreomacular traction