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Rodman, Julie A., OD, MS*; Shechtman, Diana, OD*; Sutton, Brad M., OD; Pizzimenti, Joseph J., OD; Bittner, Ava K., OD, PhD* VAST Study Group

doi: 10.1097/IAE.0000000000001792
Original Study

Purpose: To determine the prevalence and factors influencing vitreomacular adhesion (VMA) or vitreomacular traction (VMT) in subjects without maculopathy older than age 40 years.

Methods: In a prospective cross-sectional study, 1,950 eyes in 1,090 participants aged 40 to 89 years representing various ethnic groups from 14 centers in the United States underwent a comprehensive eye examination, including spectral domain optical coherence tomography. A team of independent, masked readers classified the presence or absence of VMA/VMT on spectral domain optical coherence tomography based on the International Vitreomacular Traction Study Group rubric.

Results: Across all eyes, the prevalence of VMA or VMT was 39% or 1%, respectively. For every 1-year increase in age, there was a statistically significant 7% decreased odds of having VMA or VMT (95% confidence interval [CI]: 0.89–0.96; P < 0.001), whereas African Americans had 55% significantly reduced odds of having VMA or VMT when than whites (95% CI: 0.23–0.90; P = 0.025). Vitreomacular adhesion >1,500 μm was significantly more likely than VMA <1,500 μm in younger adults (95% CI: 0.70–0.86; P < 0.001), hyperopes versus emmetropes (95% CI: 1.49–35.9; P = 0.01), primary eye care versus tertiary practices (95% CI: 0.03–0.92; P = 0.04), and patients without hyperlipidemia (95% CI: 0.04–0.83; P = 0.03).

Conclusion: Vitreomacular adhesion is highly prevalent among middle-aged adults. Diagnostic screening with spectral domain optical coherence tomography may help to accurately detect VMA or VMT, prompting routine monitoring and timely therapeutic intervention.

In this prospective cross-sectional cohort study of optical coherence tomography in 1,090 patients older than 40 years without maculopathy from diverse clinical settings, vitreomacular adhesion was found in 39% and vitreomacular traction occurred in 1%. Vitreomacular adhesion was significantly more likely to occur in middle-aged adults and among whites than African Americans.

*College of Optometry, Nova Southeastern University, Fort Lauderdale, Florida;

School of Optometry, Indiana University, Bloomington, Indiana; and

Rosenberg School of Optometry, University of the Incarnate Word, San Antonio, Texas.

Reprint requests: Ava K. Bittner, OD, PhD, College of Optometry, Nova Southeastern University, 3200 S. University Drive, Fort Lauderdale, FL 33328; e-mail:

Supported by Thrombogenics, Optovue, Carl Zeiss Meditec, and the President's Faculty Research Development Grant (PFRDG) and Health Professions Division (HPD) grant awards from the Nova Southeastern University.

None of the authors has any financial/conflicting interests to disclose.

The members of the VAST Study Group are given in Appendix 1.

© 2018 by Ophthalmic Communications Society, Inc.