scholarly journals Epidemiology of Vitreomacular Interface Disorders

2018 ◽  
pp. 220-223
Keyword(s):  
Macular Hole ◽  
Epiretinal Membrane ◽  
Visual Loss ◽  
Disease Duration ◽  
Posterior Vitreous Detachment ◽  
Vitreomacular Adhesion ◽  
Membrane Formation ◽  
Vitreous Detachment ◽  
Vitreomacular Interface ◽  
Epidemiological Characteristics

Vitreomacular interface disorders consist of a series of diseases including vitreomacular adhesion, vitreomacular traction, macular hole, and epiretinal membrane formation. They occur due to the failed progression of normal posterior vitreous detachment. Affected patients may present with metamorphopsia and varying degrees of visual loss depending on the severity of foveal disturbance and disease duration. The aim of this review is to define the epidemiological characteristics of these groups of disorders which show an increased incidence and prevalence with age in parallel with the occurrence of posterior vitreous detachment.

scholarly journals Vitreomacular Adhesion, Vitreomacular Traction, and Concurrent Diseases

2018 ◽  
pp. 256-261
Keyword(s):  
Posterior Vitreous Detachment ◽  
Age Related Macular Degeneration ◽  
Optic Coherence Tomography ◽  
Retinal Diseases ◽  
Vitreomacular Adhesion ◽  
Vitreous Detachment ◽  
Age Related ◽  
Vitreomacular Interface ◽  
Vascular Occlusions ◽  
Endothelial Growth Factor

The introduction of the optic coherence tomography in ophthalmology has been enabled us to understand the relationship between vitreomacular interface pathologies and concurrent retinal diseases. It is known that vitreomacular adhesion (VMA) and traction (VMT) develops as a result of an incomplete posterior vitreous detachment. VMA/VMT usually coincidence with age-related macular degeneration, diabetic macular edema, and retinal vascular occlusions. Some studies suggested that the complete posterior vitreous detachment is protective against these kinds of retinal diseases. It is proclaimed that VMA/VMT may have a role in the etiology and progression of these retinal diseases. And also, in the majority of the studies, it is proposed that VMA/VMT may interfere with the treatment and even worsen the result of the anti-vascular endothelial growth factor (Anti-VEGF) therapy which is used within the treatment regime of these retinal diseases. It is obvious that further studies are needed to clarify the cause-result relationship and the effectiveness of the treatment for the concurrent retinal diseases.

scholarly journals Treatment of Vitreomacular Traction with Intravitreal Injection of Perfluoropropane

2020 ◽  
Vol 75 (4) ◽  
pp. 182-187
Author(s):  
Miroslav Veith
Keyword(s):  
Intravitreal Injection ◽  
Macular Hole ◽  
Retrospective Review ◽  
Gas Injection ◽  
Posterior Vitreous Detachment ◽  
Vitreomacular Traction ◽  
Outpatient Basis ◽  
Vitreomacular Adhesion ◽  
Vitreous Detachment

Purpose: To evaluate the effect of one intravitreal injection of expansile gas in the treatment of vitreomacular traction (VMT). Methods: A retrospective review of eyes with VMT treated with singl injection of 0,3 ml of 100% C3F8 gas was performed. The procedure was performed on an outpatient basis under topical anesthesia. Results: Twelve consecutive patient (14 eyes) with symptomatic VMT underwent pneumatic vitreolysis. Mean extend of vitreomacular adhesion was 490,5 µm (408-751). A posterior vitreous detachment developed in 13 eyes (92,9 %) after a single gas injection, in 11 eyes (84,6 %) during the first month of follow-up, in 2 eyes within two month of injection. Mean baseline and last BCVA were 0,5 (0,16-0,18) and 0,67 (0,2-1,0) respectively (p < 0,001). Mean folow-up time was 5,8 (1-16) months. The procedure was also successful in two eyes, which where previously unsuccessfuly treated with ocriplasmin. One eye formed a macular hole. There were no other complication. Conclucion: Intravitreal injection of C3F8 is an effective, safe and inexpensive therapy of vitreomacular traction.

On the creation of a new unified classification of the vitreomacular interface surgical pathology

2021 ◽  
pp. 73-77
Author(s):  
V.V. Miroshnikov ◽  
◽  
Y.A. Ivanishko ◽  
S.A. Kovalev ◽  
◽  
...  
Keyword(s):  
Macular Hole ◽  
Epiretinal Membrane ◽  
Posterior Vitreous Detachment ◽  
Vitreous Body ◽  
Surgical Pathology ◽  
Main Role ◽  
Clinical Classification ◽  
Subsequent Formation ◽  
Vitreomacular Interface

The progress of modern methods the vitreomacular interface (VMI) visualization, clinical and histopathological studies are constantly expanding our understanding of the course of the macular pathological process. At the same time, the diagnostic and classification schemes we use may lose their relevance without reflecting the pathogenesis of the disease, complicating the choice of treatment tactics, and also complicating professional communication when we using various classification approaches. Aim. To offer our views on the possibility of creating a unified clinical classification of primary surgical pathology of VMI. Material and methods. Research papers related to the surgical pathology of VMI were analyzed. Results. The main role in the development of VMI pathology belongs to the vitreous body and the changes that occur in it, leading to posterior vitreous detachment (PVD). Pathological PVD is a variant of vitreomacular adhesion: vitreoschisis or separation of the entire thickness of the posterior cortex with the presence of local vitreoretinal fixation. In the first case, an epiretinal membrane (ERM) develops, which can progress to an ERM with macular pseudohole or to an ERM with foveoschisis. In the second case, pathological PVD is realized in vitreomacular traction (VMT). Depending on various factors, VMT can resolve both asymptomatically and with the formation of a defect in the retinal tissue, leading to outer lamellar macular hole (outer LMH) and the subsequent formation of a full-thickness macular hole (FTMH). If the traction does not cause strong changes, then it, disrupting the architectonics of the retina, triggers the processes leading to the LMH (which was previously called degenerative LMH), and it, in turn, in rare cases, can also become FTMH. Conclusions. We proposed the combined clinical classification scheme of VMI primary surgical pathology, which more fully reflects modern ideas about pathogenesis and allows, based on OCT data, to more clearly differentiate macular changes requiring a various surgical approach. Key words: PPV, vitreomacular interface, classification, VMT, epiretinal membrane, ERM, pseudohole, macular hole.

Pathophysiology, Classification, Clinical Diagnosis and Treatment of Primary Epiretinal Membrane

2018 ◽  
pp. 262-267
Keyword(s):  
Clinical Examination ◽  
Epiretinal Membrane ◽  
Posterior Vitreous Detachment ◽  
Internal Limiting Membrane ◽  
Non Invasive ◽  
Diagnosis And Classification ◽  
Pars Plana ◽  
Vitreomacular Interface

Epiretinal membrane (ERM), also known as macular pucker, premacular fibroplasia, premacular gliosis, or cellophane maculopathy is a common vitreoretinal interface pathology that can result in mild to moderate visual impairment with an impact on the quality of life. ERM can be classified as primary “idiopathic” or secondary. Most ERMs occur in individuals older than 50 years, and the prevalence of ERM increases as age increases. The pathological mechanisms are not entirely known, however, the posterior vitreous detachment is thought to be key. Diagnosis and classification of ERM are based on clinical examination findings. However, high resolution spectral domain-optic coherence tomographies (SD-OCTs) have proven to be more sensitive than clinical examination for the diagnosis of numerous disorders of the vitreomacular interface, including ERM. SD-OCTs enable the pre-and postoperative comparison of macular structures in a non-invasive examination. In treatment, surgical intervention entails pars plana vitrectomy with ERM removal with or without internal limiting membrane (ILM) removal. Good visual recovery was present in most patients after surgery.

Diagnosing and Treating Vitreomacular Adhesion

2011 ◽  
Vol 05 (01) ◽  
pp. 69 ◽  
Author(s):  
Paolo Carpineto ◽  
Luca Di Antonio ◽  
Agbeanda Aharrh-Gnama ◽  
Vincenzo Ciciarelli ◽  
Leonardo Mastropasqua ◽  
...  
Keyword(s):  
Posterior Vitreous Detachment ◽  
Standard Of Care ◽  
Age Related Macular Degeneration ◽  
Vitreomacular Traction ◽  
Vitreous Surgery ◽  
Vitreomacular Adhesion ◽  
Current Standard ◽  
Vitreous Detachment ◽  
Age Related ◽  
23 Gauge

Perifoveal vitreous detachment with residual vitreofoveal adhesion is considered as the first stage of posterior vitreous detachment. A key point is the transition from an innocuous vitreomacular adhesion (VMA) to a pathological vitreomacular traction (VMT). By using optical coherence tomography (OCT), VMA is defined as adhesion of the posterior hyaloid cortex involving the centre of the foveal region with or without a hyper-reflective signal on the inner surface of the retina. VMT is diagnosed when the inner macular surface slopes steeply, or sharp angulation and localised deformation of the retinal profile is detected at the VMA site. Otherwise, VMA is simply considered to be persistent adherence of the cortical vitreous. The tractional effects of perifoveal vitreous detachment cause a variety of macular pathologies determined by the size and the strength of the residual vitreoretinal adhesion. Vitreomacular adhesion plays a major role in the development of diseases such as vitreomacular traction syndrome (VMTS), macular hole, epiretinal membrane, tractional macular oedema and myopic macular retinoschisis. In addition, clinical evidence supports the theory that the course of diabetic retinopathy and age-related macular degeneration may be strongly influenced by an incomplete posterior vitreous separation. The current standard of care of vitreomacular interface pathologies is vitrectomy and membrane peeling – a procedure that is thought to relieve epiretinal traction – followed by regeneration of the retinal architecture and recovery of visual function. Over the last few years, with the introduction of 25-gauge (0.50mm) and 23-gauge (0.72mm) instruments, there has been another major shift toward transconjunctival microincisional vitrectomy surgery (MIVS). Pharmacological induction of posterior vitreous detachment (PVD) can become a further step toward a real ‘minimally invasive vitreous surgery’ for VMTS.

Optical Coherence Tomography Evaluation of Idiopathic Macular Hole Treatment by Gas-assisted Posterior Vitreous Detachment

2006 ◽  
Vol 142 (5) ◽  
pp. 869-871 ◽  
Author(s):  
Rodrigo Jorge ◽  
Rogério A. Costa ◽  
José A. Cardillo ◽  
Fausto Uno ◽  
Pedro P. Bonomo ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Macular Hole ◽  
Posterior Vitreous Detachment ◽  
Optical Coherence ◽  
Idiopathic Macular Hole ◽  
Vitreous Detachment
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