VITREOUS ATTACHMENT IN AGE-RELATED MACULAR DEGENERATION, DIABETIC MACULAR EDEMA, AND RETINAL VEIN OCCLUSION

A Systematic Review and Metaanalysis

Abstract

Purpose: 

To determine if there is an association of vitreous attachment and wet age-related macular degeneration (AMD), diabetic macular edema, and retinal vein occlusion.

Methods: 

Systematic review and metaanalysis.

Results: 

Sixteen of 1,025 articles were eligible. In wet AMD, the prevalence of vitreomacular adhesion and posterior vitreous detachment was 23% (654 eyes) and 41% (251), respectively. Vitreomacular adhesion prevalence was 2.15 times that of controls (95% confidence interval, 1.34–3.48; p = 0.002) and 2.54 times that of dry AMD (confidence interval, 0.88–7.36; p 0.09); posterior vitreous detachment prevalence was lower than controls (relative risk 0.77; confidence interval, 0.64–0.93; p = 0.007) and dry AMD (0.56; confidence interval, 0.27–1.14; p = 0.11). It was not possible to determine the prevalence of vitreous attachment in diabetic macular edema, but vitreomacular traction was present in 29% of 188 surgical cases. The prevalence of posterior vitreous detachment in eyes with central and branch retinal vein occlusion was 30% (56 eyes) and 31% (71 eyes), respectively, versus 25% (64 eyes) in controls.

Conclusion: 

Observational studies of sufficient quality indicate that eyes with wet AMD have double the expected prevalence of vitreomacular adhesion and are less likely to have a posterior vitreous detachment. More controlled studies of diabetic macular edema and retinal vein occlusion are needed.

In Brief

Metaanalysis found that wet age-related macular degeneration is associated with vitreous attachment. There is insufficient evidence to establish if diabetic macular edema and retinal vein occlusion are associated with vitreous attachment.