Anatomical configurations of vitreomacular traction syndrome

influence on clinical course and surgical outcomes

Eun Kyoung Lee, Sang Yoon Lee, Jong Young Lee, Jang Won Heo, Hyeonggon Yu, Hum Chung

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Purpose: To develop a new classification system for vitreomacular traction (VMT) syndrome according to spectral-domain optical coherence tomography (SD-OCT) imaging and to investigate the clinical course of VMT patients. Methods: This study included 68 eyes of 68 consecutive patients who were followed with observation or treated with vitrectomy for idiopathic VMT. Eyes were classified into one of three groups according to SD-OCT findings: group A (foveal pseudocyst, which was defined as the formation of cystoid cavity located in the inner part of the central fovea along with foveal thickening), group B (parafoveal retinoschisis, which was defined as intraretinal cysts or clefts along with no apparent foveal thickening), and group C (outer retinal dehiscence at the fovea, which is sometimes accompanied by foveal thinning). The minimum required follow-up period was 1 year. Clinical course and anatomical and functional outcomes were compared among the groups. Results: Twenty-seven eyes (39.7%) were included in group A, 22 eyes (32.4%) were included in group B, and 19 eyes (27.9%) were included in group C. Among the 24 eyes that were managed by observation, a significantly larger percentage of patients in group A (6/10 [60%]) exhibited more spontaneous resolution of VMT compared with those in groups B (9.1%) or C (0%) (P = 0.010). In the 44 eyes that were managed with vitrectomy, a significantly larger percentage of patients in group C (4/16 [25%]) experienced subsequent full-thickness macular hole development following vitrectomy compared with those in groups B (0%) or C (0%) (P = 0.014). The percentage of patients with photoreceptor inner segment/outer segment disruption was significantly reduced in group A after vitrectomy, with group C exhibiting the lowest recovery rate. Postoperatively, group A experienced a significantly better visual outcome than group C (P = 0.021). Conclusions: A novel configuration system offering insight into the clinical course of VMT is proposed. According to this system, anatomical and functional outcomes were favorable in group A and worse in group C.

Original languageEnglish
Pages (from-to)1631-1639
Number of pages9
JournalGraefe's Archive for Clinical and Experimental Ophthalmology
Volume257
Issue number8
DOIs
StatePublished - 5 Aug 2019

Fingerprint

Traction
Vitrectomy
Optical Coherence Tomography
Retinoschisis
Observation
Retinal Perforations
Cysts

Keywords

  • Full-thickness macular hole
  • Spectral-domain optical coherence tomography
  • Vitrectomy
  • Vitreomacular traction syndrome
  • Vitreous

Cite this

Lee, Eun Kyoung ; Lee, Sang Yoon ; Lee, Jong Young ; Heo, Jang Won ; Yu, Hyeonggon ; Chung, Hum. / Anatomical configurations of vitreomacular traction syndrome : influence on clinical course and surgical outcomes. In: Graefe's Archive for Clinical and Experimental Ophthalmology. 2019 ; Vol. 257, No. 8. pp. 1631-1639.
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title = "Anatomical configurations of vitreomacular traction syndrome: influence on clinical course and surgical outcomes",
abstract = "Purpose: To develop a new classification system for vitreomacular traction (VMT) syndrome according to spectral-domain optical coherence tomography (SD-OCT) imaging and to investigate the clinical course of VMT patients. Methods: This study included 68 eyes of 68 consecutive patients who were followed with observation or treated with vitrectomy for idiopathic VMT. Eyes were classified into one of three groups according to SD-OCT findings: group A (foveal pseudocyst, which was defined as the formation of cystoid cavity located in the inner part of the central fovea along with foveal thickening), group B (parafoveal retinoschisis, which was defined as intraretinal cysts or clefts along with no apparent foveal thickening), and group C (outer retinal dehiscence at the fovea, which is sometimes accompanied by foveal thinning). The minimum required follow-up period was 1 year. Clinical course and anatomical and functional outcomes were compared among the groups. Results: Twenty-seven eyes (39.7{\%}) were included in group A, 22 eyes (32.4{\%}) were included in group B, and 19 eyes (27.9{\%}) were included in group C. Among the 24 eyes that were managed by observation, a significantly larger percentage of patients in group A (6/10 [60{\%}]) exhibited more spontaneous resolution of VMT compared with those in groups B (9.1{\%}) or C (0{\%}) (P = 0.010). In the 44 eyes that were managed with vitrectomy, a significantly larger percentage of patients in group C (4/16 [25{\%}]) experienced subsequent full-thickness macular hole development following vitrectomy compared with those in groups B (0{\%}) or C (0{\%}) (P = 0.014). The percentage of patients with photoreceptor inner segment/outer segment disruption was significantly reduced in group A after vitrectomy, with group C exhibiting the lowest recovery rate. Postoperatively, group A experienced a significantly better visual outcome than group C (P = 0.021). Conclusions: A novel configuration system offering insight into the clinical course of VMT is proposed. According to this system, anatomical and functional outcomes were favorable in group A and worse in group C.",
keywords = "Full-thickness macular hole, Spectral-domain optical coherence tomography, Vitrectomy, Vitreomacular traction syndrome, Vitreous",
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Anatomical configurations of vitreomacular traction syndrome : influence on clinical course and surgical outcomes. / Lee, Eun Kyoung; Lee, Sang Yoon; Lee, Jong Young; Heo, Jang Won; Yu, Hyeonggon; Chung, Hum.

In: Graefe's Archive for Clinical and Experimental Ophthalmology, Vol. 257, No. 8, 05.08.2019, p. 1631-1639.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Anatomical configurations of vitreomacular traction syndrome

T2 - influence on clinical course and surgical outcomes

AU - Lee, Eun Kyoung

AU - Lee, Sang Yoon

AU - Lee, Jong Young

AU - Heo, Jang Won

AU - Yu, Hyeonggon

AU - Chung, Hum

PY - 2019/8/5

Y1 - 2019/8/5

N2 - Purpose: To develop a new classification system for vitreomacular traction (VMT) syndrome according to spectral-domain optical coherence tomography (SD-OCT) imaging and to investigate the clinical course of VMT patients. Methods: This study included 68 eyes of 68 consecutive patients who were followed with observation or treated with vitrectomy for idiopathic VMT. Eyes were classified into one of three groups according to SD-OCT findings: group A (foveal pseudocyst, which was defined as the formation of cystoid cavity located in the inner part of the central fovea along with foveal thickening), group B (parafoveal retinoschisis, which was defined as intraretinal cysts or clefts along with no apparent foveal thickening), and group C (outer retinal dehiscence at the fovea, which is sometimes accompanied by foveal thinning). The minimum required follow-up period was 1 year. Clinical course and anatomical and functional outcomes were compared among the groups. Results: Twenty-seven eyes (39.7%) were included in group A, 22 eyes (32.4%) were included in group B, and 19 eyes (27.9%) were included in group C. Among the 24 eyes that were managed by observation, a significantly larger percentage of patients in group A (6/10 [60%]) exhibited more spontaneous resolution of VMT compared with those in groups B (9.1%) or C (0%) (P = 0.010). In the 44 eyes that were managed with vitrectomy, a significantly larger percentage of patients in group C (4/16 [25%]) experienced subsequent full-thickness macular hole development following vitrectomy compared with those in groups B (0%) or C (0%) (P = 0.014). The percentage of patients with photoreceptor inner segment/outer segment disruption was significantly reduced in group A after vitrectomy, with group C exhibiting the lowest recovery rate. Postoperatively, group A experienced a significantly better visual outcome than group C (P = 0.021). Conclusions: A novel configuration system offering insight into the clinical course of VMT is proposed. According to this system, anatomical and functional outcomes were favorable in group A and worse in group C.

AB - Purpose: To develop a new classification system for vitreomacular traction (VMT) syndrome according to spectral-domain optical coherence tomography (SD-OCT) imaging and to investigate the clinical course of VMT patients. Methods: This study included 68 eyes of 68 consecutive patients who were followed with observation or treated with vitrectomy for idiopathic VMT. Eyes were classified into one of three groups according to SD-OCT findings: group A (foveal pseudocyst, which was defined as the formation of cystoid cavity located in the inner part of the central fovea along with foveal thickening), group B (parafoveal retinoschisis, which was defined as intraretinal cysts or clefts along with no apparent foveal thickening), and group C (outer retinal dehiscence at the fovea, which is sometimes accompanied by foveal thinning). The minimum required follow-up period was 1 year. Clinical course and anatomical and functional outcomes were compared among the groups. Results: Twenty-seven eyes (39.7%) were included in group A, 22 eyes (32.4%) were included in group B, and 19 eyes (27.9%) were included in group C. Among the 24 eyes that were managed by observation, a significantly larger percentage of patients in group A (6/10 [60%]) exhibited more spontaneous resolution of VMT compared with those in groups B (9.1%) or C (0%) (P = 0.010). In the 44 eyes that were managed with vitrectomy, a significantly larger percentage of patients in group C (4/16 [25%]) experienced subsequent full-thickness macular hole development following vitrectomy compared with those in groups B (0%) or C (0%) (P = 0.014). The percentage of patients with photoreceptor inner segment/outer segment disruption was significantly reduced in group A after vitrectomy, with group C exhibiting the lowest recovery rate. Postoperatively, group A experienced a significantly better visual outcome than group C (P = 0.021). Conclusions: A novel configuration system offering insight into the clinical course of VMT is proposed. According to this system, anatomical and functional outcomes were favorable in group A and worse in group C.

KW - Full-thickness macular hole

KW - Spectral-domain optical coherence tomography

KW - Vitrectomy

KW - Vitreomacular traction syndrome

KW - Vitreous

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