Effect of vitreomacular adhesion and vitreous gel on age-related reduction of macular thickness: a retrospective observational study.

Abstract:

OBJECTIVE:To investigate the effects of vitreomacular adhesion (VMA), vitreomacular separation (VMS) and absence of vitreous gel due to vitrectomy on macular thickness measured in the spectral domain optical coherence tomographic (SD-OCT) images. DESIGN:A longitudinal, retrospective, observational study. SETTING:Secondary multicentre study. PARTICIPANTS:218 eyes of 218 healthy patients and 119 vitrectomised eyes of 119 patients were studied. The healthy individuals were classified into a VMA group (54 eyes) and a VMS group (164 eyes), while the vitrectomised patients were classified into an internal limiting membrane (ILM)-on group (26 eyes) and an ILM-off group (93 eyes). In all participants, 2 Cirrus HD-OCT recordings were made with an average interval of 36 months (range 24-60 months). PRIMARY AND SECONDARY OUTCOME MEASURES:The primary outcome measure was the rate of change in macular thickness in the central sector. The secondary outcomes were the rates of change in macular thickness in the inner 4 sectors. RESULTS:The annual rate of change in the macular thickness of the central sector was 0.76±1.8 µm/year in the VMA group, -0.58±2.3 µm/year in the VMS group, -1.57±1.9 µm/year in the ILM-on group and -0.86±3.1 µm/year in the ILM-off group. There was a significant difference between the rate of the central sector thickness change in the VMA and VMS groups (p=0.0001). The presence of VMA was a significant factor associated with an increase in the central sector thickness (p=0.0055). When the healthy and ILM-on groups were compared, the rate of decrease in the central sector thickness was faster in the ILM-on group (p=0.0043). Multiple regression analyses showed that not peeling the ILM during the vitrectomy was a significant factor associated with a decrease in the central sector thickness (p=0.044). CONCLUSIONS:The presence of a VMA and a vitreous gel may help restrain the macular thickness reduction.

journal_name

BMJ Open

journal_title

BMJ open

authors

Kumagai K,Hangai M,Furukawa M,Suetsugu T,Ogino N

doi

10.1136/bmjopen-2016-012972

subject

Has Abstract

pub_date

2016-09-30 00:00:00

pages

e012972

issue

9

issn

2044-6055

pii

bmjopen-2016-012972

journal_volume

6

pub_type

杂志文章,多中心研究

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