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.

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.

scholarly journals The influence of vitreomacular adhesion on the pathogenesis and course of age-related macular degeneration

2013 ◽  
Vol 6 (1) ◽  
pp. 53-60
Author(s):  
Nikita Yuryevich Dal ◽  
Gassan Basharovich Shaar ◽  
Yuriy Sergeyevich Astakhov ◽  
Marina Mikhaylovna Lobanova
Keyword(s):  
Macular Degeneration ◽  
Posterior Vitreous Detachment ◽  
Age Related Macular Degeneration ◽  
Vitreomacular Adhesion ◽  
Vitreous Detachment ◽  
Age Related ◽  
Different Types ◽  
Age Related Changes

This article describes the age-related changes in vitreous and different types of posterior vitreous detachment. Possible effect of normal and pathological posterior vitreous detachment (in particular vitreomacular adhesion and traction syndrome) on the age-related macular degeneration course are considered. Vitrectomy and pharmacological vitreolysis potentials in the treatment of vitreomacular adhesion are discussed.

scholarly journals Macular Evaluation wıth Spectral Domain Type Optic Coherence Tomography in Eyes with Acute Nonarteritic Ischemic Optic Neuropathy at the Presentation Visit

2017 ◽  
Vol 11 (1) ◽  
pp. 17-23
Author(s):  
Oya Donmez ◽  
Gamze Kocaoglu ◽  
Aylin Yaman ◽  
Meltem Soylev Bajin ◽  
Ali Osman Saatci
Keyword(s):  
Subretinal Fluid ◽  
Posterior Pole ◽  
Age Related Macular Degeneration ◽  
Spectral Domain ◽  
Ischemic Optic Neuropathy ◽  
Optic Coherence Tomography ◽  
Vitreomacular Adhesion ◽  
Domain Type ◽  
Age Related ◽  
Fellow Eyes

Purpose: To evaluate the macula with spectral domain type optic coherence tomography (OCT) in eyes with acute nonarteritic anterior ischemic optic neuropathy (NAION) at the presentation visit. Methods: Medical charts of the 133 patients who received the diagnosis of acute NAION between January 2008 and July 2014 at the Neuro-ophthalmology unit of Dokuz Eylul University were reviewed retrospectively. Sixtythree patients within 30 days of symptom onset with available baseline spectral domain type macular OCT were included in this study. Clinical and macular characteristics of the affected eye were assessed and compared to the fellow eyes. Results: Sixty-three eyes of 63 patients comprised the study group. Twenty one study eyes (33.3%) had normal posterior pole, 22 (34.9%) some evidence of subretinal fluid, 10 (15.8%) vitreomacular adhesion, five (7%) age-related macular degeneration related changes, four (6%) epiretinal membrane and one (1%) previous grid laser scars. On the other hand, 41 of 63 the fellow eyes (65%) had normal posterior pole, ten (15.8%), vitreomacular adhesion, seven (10.7%), age-related macular degeneration related changes, three (4%) epiretinal membrane and two (3%) other type of changes. OCT scan passing through the fovea exhibited 10 or more hyperreflective dots in 10 (15%) of the study eyes whereas two of the fellow eyes (3.2%) had 10 or more hyperreflective dots. Conclusion: Macular OCT can be a part of the routine neuroophthalmologic examination in patients with acute NAION not only to show the NAION related changes such as the subretinal fluid accumulation but also to identify the other coexistent macular abnormalities.

scholarly journals Physiology of Vitreous and Vitreomacular Interface and Age-Related Changes

2018 ◽  
pp. 213-219
Keyword(s):  
Extracellular Matrix ◽  
Posterior Vitreous Detachment ◽  
Natural Aging ◽  
Posterior Segment ◽  
Vitreomacular Adhesion ◽  
Vitreoretinal Interface ◽  
Age Related ◽  
Ocular Structure ◽  
Vitreomacular Interface ◽  
Age Related Changes

Vitreous is an important ocular structure in the normal physiology and pathologic conditions of the posterior segment. Vitreous is a gel-like composite structure and forms an extracellular matrix that occupies the biggest space in the eye. The healthy vitreous gel reduces oxygen tension and protects vitreous, retina, and lens from oxidative damage. Vitreous plays an important role in the refraction of the eye, preserving the transparency with regular interaction of the macromolecules contained therein. Vitreous suffer from continuous physical tension and this results in important changes. Particularly age-related degeneration in the structure of the vitreous gel leads to a decrease in vitreoretinal adhesion. As part of natural aging, the posterior vitreous detachment process may become pathologic when the vitreoretinal interface weakens simultaneously with vitreous liquefaction. In this process, vision-threatening diseases such as vitreomacular adhesion, vitreomacular traction, and macula hole may appear.

Effect of posterior vitreous detachment on treat-and-extend versus monthly ranibizumab for neovascular age-related macular degeneration

2019 ◽  
Vol 104 (7) ◽  
pp. 899-903 ◽  
Author(s):  
Sebastian M Waldstein ◽  
Leonard Coulibaly ◽  
Sophie Riedl ◽  
Amir Sadeghipour ◽  
Bianca S Gerendas ◽  
...  
Keyword(s):  
Macular Degeneration ◽  
Posterior Vitreous Detachment ◽  
Median Number ◽  
Age Related Macular Degeneration ◽  
Controlled Clinical Trial ◽  
Vitreous Detachment ◽  
Treat And Extend ◽  
Age Related ◽  
Treatment Naïve ◽  
The Impact

AimsTo investigate the impact of posterior vitreous detachment (PVD) on the efficacy of treat-and-extend (T&E) ranibizumab in neovascular age-related macular degeneration.MethodsIn a post hoc analysis of a randomised controlled clinical trial, spectral-domain optical coherence tomography images of treatment-naïve patients randomised to receive T&E (n=265) or monthly (n=264) ranibizumab for 12 months were included. Certified, masked graders diagnosed the presence or the absence of complete PVD. The main outcome measures were the mean change in best-corrected visual acuity (BCVA) and central retinal thickness (CRT) at month 12, the number of administered ranibizumab injections and the proportion of patients extended to more than 8 weeks.ResultsAt baseline, complete PVD was present in 51% and 56% of patients in the monthly and T&E arms, respectively. Mean change in BCVA at month 12 was +9.0 (PVD) vs +9.5 letters (no PVD, p=0.78) in monthly treated eyes, and +6.0 (PVD) vs +7.5 letters (no PVD, p=0.42) in T&E treated eyes. Conversely, mean change in CRT at month 12 was −174 (PVD) vs −173 µm (no PVD, p=0.98) in the monthly arm, and −175 (PVD) vs −164 µm (no PVD, p=0.58) in the T&E arm. In T&E treated patients, the median number of injections was eight vs nine (p=0.035). 71% of PVD eyes were extended successfully, compared with 55% of eyes without PVD (p=0.005).ConclusionPVD was not found to impact functional and anatomical outcomes of T&E ranibizumab therapy. However, patients without a complete PVD required more retreatments and were significantly less likely to be successfully extended.Trial registration numberNCT01948830

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