Department of Ophthalmology, King's College Hospital, London, United Kingdom.
Retina. 2013 Sep;33(8):1503-11. doi: 10.1097/IAE.0b013e31829232fd.
Symptomatic vitreomacular adhesion describes symptomatic loss of visual function as a result of vitreous traction at the macula.
Literature review.
Symptomatic vitreomacular adhesion can occur in isolation as vitreomacular traction, which may lead to the development of a macular hole, or it may occur alongside epiretinal membrane. It is likely to be associated with age-related macular degeneration and possibly diabetic maculopathy, although this is less certain. The treatment depends largely on the cause, but options include observation, vitrectomy, and pharmacologic vitreolysis. Small uncontrolled trials have also explored the use of an intravitreal gas bubble as a means of releasing VMA. If all cases of sVMA are considered together, then the burden of illness is substantial, with a prevalence of ∼0.35 per 100 population (excluding epiretinal membrane). Furthermore, there may be many more cases of undiagnosed sVMA.
The recent introduction of ocriplasmin is likely to increase interest in sVMA. Clinical trials suggest that it has a role in the treatment of vitreomacular traction and Stages 1 to 3 macular holes but not primarily as a treatment of epiretinal membrane. Its role in other diseases associated with VMA remains to be determined.
症状性玻璃体黄斑粘连是指由于黄斑区玻璃体牵引而导致视觉功能丧失的症状。
文献回顾。
症状性玻璃体黄斑粘连可单独发生，表现为玻璃体黄斑牵引，可能导致黄斑裂孔的形成，也可与视网膜前膜同时发生。它可能与年龄相关性黄斑变性和糖尿病性黄斑病变有关，但这一点不太确定。治疗主要取决于病因，但选择包括观察、玻璃体切除术和药物性玻璃体溶解术。一些小型非对照试验也探讨了使用眼内气体泡来释放 VMA 的方法。如果将所有 sVMA 病例都考虑在内，那么疾病负担是相当大的，患病率约为每 100 人中有 0.35 例（不包括视网膜前膜）。此外，可能还有更多未确诊的 sVMA 病例。
最近 ocriplasmin 的引入可能会增加对 sVMA 的兴趣。临床试验表明，它在治疗玻璃体黄斑牵引和 1 至 3 期黄斑裂孔方面有一定作用，但主要不是作为视网膜前膜的治疗方法。它在与 VMA 相关的其他疾病中的作用仍有待确定。
