|Pars Plana Vitrectomy VS Observation for Vitreomacular Traction Syndrome|
|Ahoor Mohamadhosein1, Araz Mohammadzadeh1, Leila Alizadeh Ghavidell1|
|1Department of Ophthalmology,Tabriz University Of Medical Science, Tabriz, Iran|
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Keywords : Vitreomacular traction, Spontaneous resolution, Vitrectomy for vitreomacular traction syndrome
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Objectives: This study aims to estimate the natural course of vitreomacular traction (VMT) disorder during a 6-month follow-up using high-resolution spectral-domain optical coherence tomography (SD-OCT) and to evaluate the visual and anatomical outcomes of patients who underwent follow up or vitrectomy for vitreomacular traction syndrome.
Materials and Methods: In this prospective study, 45 eyes from 35 patients with vitreomacular traction (VMT) syndrome underwent spectral-domain optical coherence tomographic imaging and eye examinations. All patients were observed for 6 subsequent months. The patients were evaluated by SD-OCT and eye examination. Patients not showing spontaneous resolution of adhesion during this period, underwent three port standard pars plana vitrectomy. Two patients were excluded from the study, then all the patients were observed for 12 months. The mean observation period of all the patients was 18 months. Changes in visual acuity before and after study were compared between the two groups.
Results: The mean age of patients was 64.21±7.712 years (between 51 to 80 years). After 6 months follow-up, 20 patients (44.45%) showed spontaneous release of vitreomacular traction. Mean logMAR visual acuity improved from 0.7042±0.21 (Snellen"s equivalent of 20/100) to 0.585±78( Snellen"s equivalent of 20/76). Baseline visual acuity was greater than or equal to log Mar VA 0.7(Snellen"s equivalent of 20/100) in most of the patients who showed a spontaneous resolution of VMT after 6 months of follow-up. All patients with spontaneous release of VMT, showed improvement in visual acuity compared to the baseline, from mean baseline log MAR VA of 0.5650 (Snellen"s equivalent of 20/73) to 0.4700 (Snellen"s 20/59). In vitrectomy group, the mean baseline logMAR VA improved from 0.8435(Snellen"s equivalent 20/138) to 0.7000(Snellen"s equivalent 20/100).
Conclusion: Approximately 44.5% of patients showed spontaneous resolution of vitreoretinal adhesion during the six-month follow-up. The higher the initial visual acuity, the higher the spontaneous separation rate, and eventuallya better visual outcome.
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