Vitreomacular Traction Syndrome

SALIENT FEATURES

Incomplete separation of the posterior hyaloid from the macula during the posterior vitreous detachment process with resulting traction is defined as vitreomacular traction (VMT).
VMT syndrome is defined as VMT with associated epiretinal membrane.
VMT frequency increases with age and is estimated at a prevalence of 1.6% in the population. It is present in 23% of exudative (wet) age-related macular degeneration (AMD) eyes and 29% of diabetic macular edema (DME) eyes.¹
VMT may be symptomatic with metamorphopsia, photopsia, blurred vision, and decreased visual acuity, affecting quality of life.²
VMT is associated with a range of vision-impairing macular diseases such as epiretinal membrane (ERM), macular hole (MH), age-related macular degeneration, diabetic retinopathy, and diabetic macular edema.
Prognosis, especially following treatment, depends on a variety of factors including concurrent macular disease, baseline visual acuity, age, ERM presence, and vitreomacular adhesion (VMA) diameter.³

OCT IMAGING

Optical coherence tomography (OCT) is the gold standard for diagnosis, surveillance, and posttreatment monitoring of VMT.

Traction between the posterior hyaloid and the foveal center results in the key OCT findings associated with VMT (Figures 34.1, 34.2, 34.3):

Altered foveal contour with anterior traction on the inner retinal surface.

FIGURE 34.1 A, Optical coherence tomography (OCT) image demonstrating vitreomacular traction (VMT) with trace epiretinal membrane (ERM) with loss of foveal contour and small amount of intraretinal fluid. B, Progression of VMT with additional intraretinal fluid accumulation. C, Postoperative OCT scan showing resolution of VMT but persistent ERM.

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