PURPOSE OF REVIEW: To describe recent evidence regarding the clinical management of vitreomacular traction (VMT). RECENT FINDINGS: Recent studies have reported favorable outcomes in patients with VMT managed with observation, pharmacologic vitreolysis with ocriplasmin, and intravitreal perfluoropropane gas. Subgroup analysis has identified features associated with spontaneous release of VMT as well as features associated with successful pharmacologic release of VMT with ocriplasmin. SUMMARY: Observation may be an appropriate initial recommendation for patients with mild VMT. When treatment is necessary, pharmacologic vitreolysis with ocriplasmin is an effective nonsurgical therapeutic option. Careful patient selection improves success rates with ocriplasmin. Further study is necessary to establish the efficacy of intravitreal perfluoropropane gas for VMT as well as the efficacy of ocriplasmin in patients with VMT and concurrent retinal disease. As these treatments are more widely used, prospective data will continue to clarify their risk/benefit profile.
PURPOSE OF REVIEW: To describe recent evidence regarding the clinical management of vitreomacular traction (VMT). RECENT FINDINGS: Recent studies have reported favorable outcomes in patients with VMT managed with observation, pharmacologic vitreolysis with ocriplasmin, and intravitreal perfluoropropane gas. Subgroup analysis has identified features associated with spontaneous release of VMT as well as features associated with successful pharmacologic release of VMT with ocriplasmin. SUMMARY: Observation may be an appropriate initial recommendation for patients with mild VMT. When treatment is necessary, pharmacologic vitreolysis with ocriplasmin is an effective nonsurgical therapeutic option. Careful patient selection improves success rates with ocriplasmin. Further study is necessary to establish the efficacy of intravitreal perfluoropropane gas for VMT as well as the efficacy of ocriplasmin in patients with VMT and concurrent retinal disease. As these treatments are more widely used, prospective data will continue to clarify their risk/benefit profile.
Authors: Thomas Bertelmann; Joachim Wachtlin; Stefan Mennel; Michael J Koss; Mathias M Maier; Ricarda G Schumann; Sara Kazerounian; Hanna Daniel; Steffen Schmitz-Valckenberg Journal: Graefes Arch Clin Exp Ophthalmol Date: 2017-04-07 Impact factor: 3.117