Codenotti Marco, Iuliano Lorenzo, Fogliato Giovanni, Querques Giuseppe, Bandello Francesco
Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy.
Graefes Arch Clin Exp Ophthalmol. 2014 Nov;252(11):1729-35. doi: 10.1007/s00417-014-2645-z. Epub 2014 Apr 25.
To analyze the course of eyes with vitreomacular traction (VMT), and to find by optical coherence tomography (OCT) possible correlations between vitreomacular interface area changes and the chance of spontaneous VMT resolution.
Retrospective analysis of all consecutive patients presenting with VMT over a 24-month period. We introduced a novel OCT evaluation model to assess the vitreomacular interface area. Central foveal thickness (CFT) and best-corrected visual acuity (BCVA) were also analyzed throughout follow-up.
Twenty-six eyes of 18 symptomatic patients were followed for 12.9 ± 4.8 months. Eyes were subdivided into groups according to their clinical course. Six eyes (23%) had a spontaneous resolution of the VMT (group A), and the interface area before its occurrence (39565 ± 26409 μm(2)) was smaller than at study entry (99434 ± 38819 μm(2); p = 0.03). The interface area did not significantly change throughout follow-up in the group that underwent surgery (group B, 11 eyes) and in the group that remained overall stable (group C, 9 eyes). At baseline, the interface area was smaller in group A compared to groups with non-resolved VMT (mean values of group B and C together) (785095 ± 920721 μm(2); p = 0.002). CFT and BCVA did not significantly change in any of the studied groups. Vitreomacular interface area of 101002 μm(2) was identified as the threshold value separating the spontaneous VMT resolution group from the group with non-resolved VMT (p < 0.001).
The more the vitreomacular interface area reduced over time, the higher was the chance of spontaneous VMT resolution. An area below 101002 μm(2) was the threshold value indicating a higher chance of spontaneous release of VMT.
分析玻璃体黄斑牵拉(VMT)患者的病情发展过程,并通过光学相干断层扫描(OCT)找出玻璃体黄斑界面面积变化与VMT自发缓解可能性之间的潜在关联。
对连续24个月内所有出现VMT的患者进行回顾性分析。我们引入了一种新型OCT评估模型来评估玻璃体黄斑界面面积。在整个随访过程中,还对中心凹厚度(CFT)和最佳矫正视力(BCVA)进行了分析。
18例有症状患者的26只眼接受了12.9±4.8个月的随访。根据临床病程将这些眼分为不同组。6只眼(23%)的VMT自发缓解(A组),其发生前的界面面积(39565±26409μm²)小于研究开始时(99434±38819μm²;p = 0.03)。接受手术的组(B组,11只眼)和总体保持稳定的组(C组,9只眼)在整个随访过程中界面面积无显著变化。基线时,A组的界面面积小于VMT未缓解组(B组和C组合并均值)(785095±920721μm²;p = 0.002)。在任何研究组中,CFT和BCVA均无显著变化。101002μm²的玻璃体黄斑界面面积被确定为区分VMT自发缓解组和VMT未缓解组的阈值(p < 0.001)。
随着时间推移,玻璃体黄斑界面面积减少越多,VMT自发缓解的可能性越高。低于101002μm²的面积是表明VMT自发松解可能性较高的阈值。