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PREDICTIVE FACTORS OF VISUAL OUTCOME FOR VITREOMACULAR TRACTION SYNDROME AFTER VITRECTOMY

Yang, Chang-Sue, MD, MHA*,†,‡; Hsieh, Ming-Hung, MD*; Chang, Yu-Fan, MD*,†; Wang, Chiao-Yu, MD*; Chen, Shih-Jen, MD, PhD*,†

doi: 10.1097/IAE.0000000000001760
Original Study

Purpose: To assess the long-term functional and anatomical outcomes for vitreomacular traction syndrome (VMT) after vitrectomy and to analyze the predictive factors regarding visual outcome.

Methods: A retrospective, consecutive case series of 22 eyes in 22 patients with VMT who underwent vitrectomy to relieve macular edema were studied. Eyes were classified into two groups according to the diameter of vitreomacular adhesion based on spectral domain optical coherence tomography: Group 1 (14 eyes) focal attachment ≤1,500 μm; and Group 2 (eight eyes) broad attachment >1,500 μm.

Results: Mean postoperative follow-up was 25.4 months (range, 6–68). The preoperative mean logarithm of the minimal angle of resolution visual acuity was 0.73 (20/107), which significantly improved to 0.49 (20/62) postoperatively (P < 0.01). Seventeen eyes (77%) had Snellen visual acuity improvement ≧ two lines, and nine eyes had improvement ≧ three lines. The improvement of visual acuity was significantly better in Group 1 than in Group 2 (2.7 lines vs. 0.8 lines) (P = 0.03). The preoperative mean central macular thickness was 563 μm ± 176 μm, which significantly improved to 298 μm ± 69 μm postoperatively (P < 0.01). In multivariate analysis, better final visual acuity was significantly associated with Group 1 VMT (P < 0.01) and with shorter symptom duration (P < 0.01). Greater improvement of visual acuity was also significantly associated with younger age of patients (P = 0.02) and with Group 1 VMT (P < 0.01). In linear regression analysis, patients with longer symptom duration had worse final visual acuity (β = 0.02) and patients of younger age had greater visual acuity improvement (β = 0.008).

Conclusion: Most patients of VMT gained significant functional and anatomical improvements after vitrectomy. Group 1 optical coherence tomography pattern, shorter symptom duration, and younger age are significant predictive factors of better visual outcome.

Most patients of vitreomacular traction syndrome gained significant functional and anatomical improvement after vitrectomy. The authors highlighted the different patterns of vitreomacular traction syndrome determined by optical coherence tomography and its correlation with visual outcome. In multivariate analysis, Group 1 optical coherence tomography pattern, shorter symptom duration, and younger age are predictive factors of better visual outcome.

*Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan;

Department of Ophthalmology, National Yang-Ming University School of Medicine, Taipei, Taiwan; and

Department of Ophthalmology, Taipei Medical University, Taipei, Taiwan.

Reprint requests: Chang-Sue Yang, MD, MHA, Department of Ophthalmology, National Yang-Ming University, Taipei Veterans General Hospital, 201 Sec. 2, Shih-Pai Road, Taipei, Taiwan 11217; e-mail: cyang2875@gmail.com

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

© 2018 by Ophthalmic Communications Society, Inc.