Retrospective analysis gives insights on natural history of vitreomacular traction
HAMBURG — Retrospective analysis of patient records carried out at the Department of Ophthalmology of Leuven, Belgium, provided information on the natural history of untreated vitreomacular traction with or without macular hole.
“We looked back at our records between 2009 and 2012 when ocriplasmin was not yet available and ‘wait and see’ was the primary strategy. We found 509 patients with vitreomacular interface diseases, including vitreomacular adhesion, VMT and macular hole with or without traction,” Peter Stalmans, MD, said at the Euretina meeting here.
Mean age of this group of patients was 70 years, with females being more frequently affected than men. Visual acuity decreased with the presence of macular hole. Metamorphopsia was found to be a common symptom of vitreomacular traction (VMT), occurring in 40% of the cases and increasing with the progression of the disease.
“We had a fairly long follow-up, 1.8 years for VMA and VMT and 2.5 years for macular hole,” Stalmans said.
The fellow eye was often involved. Vitrectomy rate was higher in the macular hole group.
“Vitrectomy was only considered in 20% of VMT patients. Most of them were only kept under observation,” he said.
Spontaneous release occurred only in 22% of the eyes. In the majority of cases, it occurred after 9 months. After 2 years, no further cases of spontaneous resolution were found.
Macular hole with adhesion detached in the first half-year in 17% of the eyes, progressing to the stage where it would not be treatable with ocriplasmin (Jetrea, ThromboGenics).
Disclosure: Stalmans is consultant to ThromboGenics and Alcon.