Título

PREVALENCE OF SYMPTOMATIC VITREORETINAL TRACTION DETECTED BY SPECTRAL-DOMAIN OPTICAL COHERENCE TOMOGRAPHY IN FELLOW EYES OF PATIENTS WITH FULL THICKNESS MACULAR HOLE

Objetivo

Purpose: the authors described the prevalence as well as the natural history of patients with symptomatic idiopathic vitreomacular traction [VMT] in fellow eyes of patients with full thickness macular holes [FTMH] based on spectral domain optical coherence tomography [SD-OCT].

Método

This study consists in a retrospective, observational clinical study to assess the vitreoretinal interface in fellow eyes of patients with full thickness macular holes [FTMH] based on spectral domain optical coherence tomography [SD-OCT] examinations. Patients with abnormalities in the vitreoretinal interface were diagnosed by OCT B-scans, and classified according to the International Vitreomacular Traction Study [IVTS] Group [Ophthalmology, 2013], and subjects subdivided with SD-OCT findings consistent with idiopathic VMT were graded according John et al [Retina, 2014]. All patients were followed for at least 6 months.

Resultado

There were 40 patients [12 men] with a mean age of 64.8 ± 12.8 years. Patients were followed for a mean of 20.4 ± 22.4 months. Thoroughly 28 fellow eyes [70.0%] of patients with FTMH at baseline depicted symptomatic VMT. During the follow-up period, 6 patients [21.4%] had spontaneous resolution of the VMT without abnormalities of foveal anatomy on SD-OCT. Evaluating 22 patients that were diagnosed with symptomatic VMT at baseline, 10 eyes had Grade 1, 6 eyes had Grade 2, and 6 eyes had Grade 3 SD-OCT findings. Subgroup analysis based on baseline SD-OCT grade showed that 38.0% of Grade 2 and 3 [12 of 22] developed FTMH or lamellar macular hole within a 12 months period.

Conclusão

The baseline SD-OCT grade may predict the progression to FTMH, specially in patients with advanced vitreomacular traction at baseline. The authors suggest a close follow-up with SD-OCT structural B-scans aiming to provide an appropriate management of patients with Grade 3 VMT. Further studies are necessary to confirm these outcomes.