Influence of vitreomacular adhesion on the development of exudative age-related macular degeneration: 4-year results of a longitudinal study.

PURPOSE

To investigate the influence of vitreomacular adhesion (VMA) on development of choroidal neovascularization (CNV) in eyes with age-related macular degeneration.

METHODS

In a prospective study, patients with Age-Related Eye Disease Study Category IV age-related macular degeneration underwent standardized examinations, including optical coherence tomography and fluorescein angiography every 3 months for 4 years. Vitreomacular adhesion was evaluated using time- and spectral-domain optical coherence tomography. Development of CNV was detected using fluorescein angiography and optical coherence tomography. Incidences of CNV were compared concerning the presence or absence of VMA.

RESULTS

Forty-nine patients were available for follow-up according to protocol. Vitreomacular adhesion was present at baseline in 18% (9 of 49) and absent in 82% (40 of 49) of patients. Thirty-seven percent of patients (18 of 49) developed exudative changes during the observation period. In patients with preexisting VMA, de novo development of CNV occurred in 33% (3 of 9). In patients without VMA, 38% developed CNV (15 of 40). Mean interval from baseline to disease progression was 20 ± 19 months in patients with VMA and 22 ± 13 months in patients without VMA. There was no significant difference between the groups regarding rate of CNV development or time to disease progression (P = 0.64).

CONCLUSION

No significant influence of VMA on the development of exudative age-related macular degeneration could be found during a 4-year prospective observation of a high-risk cohort.