Purpose: To evaluate the relationship between preoperative structure and surgical outcome in eyes with macular edema caused by vitreomacular traction (VMT).
Methods: A retrospective review of 24 eyes of 24 patients with macular edema due to VMT who underwent vitrectomy to relieve macular traction is presented. The diagnosis of VMT was based on findings of clinical examination and optical coherence tomography (OCT). Preoperative and postoperative best-corrected visual acuity was converted to logarithm of the minimal angle of resolution visual acuity for analysis. Patients with a minimum of 6 months of follow-up were included.
Results: Eyes were categorized into one of the three groups based on the relationship of the posterior hyaloid to the retina: Group 1 (11 eyes) had focal vitreofoveal hyaloidal attachment with perifoveal separation; Group 2 (6 eyes) had vitreoretinal hyaloidal attachment to the macula and papillomacular bundle; and Group 3 (7 eyes) had broad vitreofoveal attachment with a fine epiretinal membrane over the posterior pole. Mean postoperative follow-up was 9.8 months (range, 6-15 months). Twenty-one eyes (87.5%) had at least 1 line of improvement in visual acuity (logMAR). Improvement in vision was significantly greater in the eyes in Group 1 (2.82 +/- 1.47 lines) than in those in Group 2 (0.83 +/- 1.17 lines; P = 0.004) or Group 3 (1.29 +/- 0.49 lines; P = 0.036). Visual outcome correlated with symptom duration (P = 0.024), VMT category (Group 1, 2, or 3; P = 0.013), and preoperative central macular thickness (CMT) by OCT (P = 0.007). A decrease in mean CMT was also significantly correlated with VMT configuration (Group 1, 2, or 3; P = 0.041).
Conclusions: Visual outcome after vitrectomy for VMT is correlated with preoperative vitreomacular structure, duration of symptoms, and preoperative CMT.