Purpose

To examine the natural history of vitreomacular traction syndrome (VMTS) in the absence of other ocular comorbidities.

Design

Retrospective clinical case series.

Participants

A total of 183 eyes of 159 patients diagnosed with VMTS with no other ocular comorbidity.

Methods

Patients with VMTS were identified from an OCT database at Moorfields Eye Hospital, London. Sequential OCT scans and patient notes were reviewed over a minimum period of 6 months. Data collected included patient demographics, best-corrected visual acuity, and OCT features of vitreomacular adhesion. Contingency tests and binary logistic modeling were used to identify baseline predictors of stability and progression.

Main Outcome Measures

The rates of spontaneous resolution (defined by release of traction), progression to full-thickness macular hole, and surgical intervention were analyzed.

Results

Presenting visual acuity was 0.3±0.3 logMAR units. The mean length of follow-up was 17.4±12.1 months. During this period, VMTS persisted in 60% and resolved in 20% (occurring on average at 15 months). Of the remainder, 12% developed a macular hole and 8% elected to proceed with surgery for symptoms. Focal adhesion <1500 μm was present in 87%. A premacular membrane with macular pucker (PMM) was present in 20%. With persistent VMTS, vision and central foveal thickness remained unchanged. The relative risk of resolution increased in those cases with better presenting visual acuities, lesser foveal thicknesses, and no associated PMMs; vision significantly improved in those cases with resolution.

Conclusions

VMTS persists in the majority of patients but despite this, visual acuities did not deteriorate significantly over the study period unless patients developed a full-thickness macular hole or required surgical intervention for symptoms. Resolution spontaneously occurred in 20%, with an improvement in vision.

中文翻译：

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OCT对玻璃体黄斑牵引综合征自然史的研究

目的

在没有其他眼部合并症的情况下检查玻璃体黄斑牵引综合征 (VMTS) 的自然病程。

设计

回顾性临床病例系列。

参与者

共有 159 名患者的 183 只眼被诊断为 VMTS，没有其他眼部合并症。

方法

VMTS 患者是从伦敦 Moorfields 眼科医院的 OCT 数据库中确定的。连续 OCT 扫描和患者记录在至少 6 个月的时间内进行了审查。收集的数据包括患者人口统计学、最佳矫正视力和玻璃体黄斑粘连的 OCT 特征。使用权变检验和二元逻辑模型来确定稳定性和进展的基线预测因子。

主要观察指标

分析了自发消退率（由牵引力的释放定义）、进展到全层黄斑裂孔和手术干预的发生率。

结果

呈现视力为 0.3±0.3 logMAR 单位。平均随访时间为 17.4±12.1 个月。在此期间，VMTS 持续 60%，20% 解决（平均发生在 15 个月）。在其余的人中，12% 的人出现了黄斑裂孔，8% 的人选择进行手术治疗症状。87% 存在 <1500 μm 的粘着斑。20% 存在黄斑皱褶 (PMM) 的黄斑前膜。VMTS 持续存在时，视力和中央凹厚度保持不变。在具有更好的视力、较小的中心凹厚度和没有相关 PMM 的情况下，分辨率的相对风险增加；在有分辨率的情况下，视力显着改善。

结论

VMTS 在大多数患者中持续存在，但尽管如此，除非患者出现全层黄斑裂孔或需要对症状进行手术干预，否则视力在研究期间并未显着恶化。20% 的人自发解决，视力有所改善。