To determine if there is an association of vitreous attachment and wet age-related macular degeneration (AMD), diabetic macular edema, and retinal vein occlusion.
Systematic review and metaanalysis.
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.
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.
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.
*Guthrie Clinic, King's College Hospital, London, United Kingdom;
†Department of Social Policy, LSE Health, London School of Economics and Political Science, London, United Kingdom;
‡Department of Primary Care and Public Health Sciences; and
§Department of Ophthalmology, King's College London, London, United Kingdom.
Reprint requests: Timothy L. Jackson, FRCOphth, PhD, Guthrie Clinic, King's College Hospital, London SE5 9RS, United Kingdom; e-mail: firstname.lastname@example.org
This project was supported by an unrestricted educational grant from Thrombogenics.
A component of the article has been accepted for poster presentation at the Royal College of Ophthalmologists’ Meeting in the United Kingdom.
T. Jackson is a Consultant to Thrombogenics.
The authors declare no conflict of interest.