High-resolution optical coherence tomography after surgery for vitreomacular traction: a 2-year follow-up.

PURPOSE

To characterize the morphologic changes in vitreomacular traction (VMT) before and after surgery using spectral-domain optical coherence tomography (SD OCT) and to identify patterns relevant to visual function.

DESIGN

Prospective, interventional case series.

PARTICIPANTS

Thirty eyes of 30 consecutive patients with visual acuity of less than 20/32 resulting from idiopathic VMT.

METHODS

A conventional 20-gauge 3-port vitrectomy was performed, including removal of the epiretinal membrane (ERM) and internal limiting membrane. Examinations were performed 1 day before surgery and 1 and 3 days as well as 1, 3, 6, 12, and 24 months after surgery. The SD OCT scan sets were analyzed with regard to central retinal thickness (CRT), retinal volume (RV), graded parameters of inner/outer retinal layer integrity (ILI/OLI), presence of retinal surface folds (RSF), and foveal contour.

MAIN OUTCOME MEASURES

Visual acuity and morphologic characteristics of the inner and outer retinal layers revealed by SD OCT.

RESULTS

Spectral-domain OCT revealed a complete absence of the ERM and early release of traction forces in each eye. Best-corrected visual acuity increased progressively over 24 months. Morphologically, RSF resolved within 1 month after surgery, followed by a marked decrease in CRT and RV over the next 3 months. There was no significantly correlation between RSF, CRT, or RV with functional improvement, and CRT and RV did not return to physiologic values. Recovery of ILI and OLI proceeded slowly, reaching significance at 12 months, and correlated strongly with visual function.

CONCLUSIONS

Spectral-domain OCT seems to be a valuable method for evaluating retinal changes after surgery for VMT. Reconstitution of neurosensory layers was identified as the most relevant parameter for visual improvement.