Christoph Paul1, P Krug2, H H Müller3, J Wachtlin4,5, S Mennel6, S Müller7, S Schmitz-Valckenberg7, T Bertelmann2,8, R G Schumann9. 1. Department of Ophthalmology, Philipps-University Marburg, Baldingerstraße, 35043, Marburg, Germany. paulc@staff.uni-marburg.de. 2. Department of Ophthalmology, University Medical Center Goettingen, Goettingen, Germany. 3. Institute of Medical Biometry and Epidemiology, Philipps-University Marburg, Marburg, Germany. 4. Department of Ophthalmology, Sankt Gertrauden-Krankenhaus, Berlin, Germany. 5. The Brandenburg Medical School Theodor Fontane, Neuruppin, Germany. 6. Department of Ophthalmology, Feldkirch State Hospital, Feldkirch, Austria. 7. Department of Ophthalmology, University of Bonn, Bonn, Germany. 8. ARTEMIS Eye Clinic, Dillenburg, Germany. 9. Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany.
Abstract
PURPOSE: In daily practice, vitreomacular traction (VMT) is described by the horizontal diameter of its attachment site implying a regular round shape of VMT. We investigated the deviation from this circular area of vitreous traction in patients with VMT. METHODS: A retrospective analysis of optical coherence tomography (OCT) scans was performed. The area of vitreomacular attachment was determined using six radial OCT scans (Ameasured). The assumed circular area of traction was calculated based on measuring the maximal horizontal diameter for comparison (Acircular). RESULTS: Thirty-seven eyes of 37 patients with pure VMT were included. Patients' mean age was 72.8 ± 8.2 years. Mean horizontal VMT diameter was 400.8 ± 230.5 μm (median 361 μm; range 44-991 μm). While there was no difference between mean areas of traction for Acircular and Ameasured (P = 0.93), the individual difference (|Acircular - Ameasured|) was 0.042 (± 0.044) mm2 in mean or relative 73.0% (± 135.8%). A difference of ≥ 30% of Ameasured to Acircular was found in 16 eyes (43.2%) and ≥ 100% in 7 eyes (18.9%), respectively. CONCLUSION: Vitreous attachment sites possess an irregular non-circular shape in a significant number of eyes with VMT. Consequently, the area of traction appears inaccurately described by its horizontal VMT diameter alone. As the area of traction is important for therapeutic recommendation, our results emphasize the need for a more precise description of the area of traction in eyes with VMT.
PURPOSE: In daily practice, vitreomacular traction (VMT) is described by the horizontal diameter of its attachment site implying a regular round shape of VMT. We investigated the deviation from this circular area of vitreous traction in patients with VMT. METHODS: A retrospective analysis of optical coherence tomography (OCT) scans was performed. The area of vitreomacular attachment was determined using six radial OCT scans (Ameasured). The assumed circular area of traction was calculated based on measuring the maximal horizontal diameter for comparison (Acircular). RESULTS: Thirty-seven eyes of 37 patients with pure VMT were included. Patients' mean age was 72.8 ± 8.2 years. Mean horizontal VMT diameter was 400.8 ± 230.5 μm (median 361 μm; range 44-991 μm). While there was no difference between mean areas of traction for Acircular and Ameasured (P = 0.93), the individual difference (|Acircular - Ameasured|) was 0.042 (± 0.044) mm2 in mean or relative 73.0% (± 135.8%). A difference of ≥ 30% of Ameasured to Acircular was found in 16 eyes (43.2%) and ≥ 100% in 7 eyes (18.9%), respectively. CONCLUSION: Vitreous attachment sites possess an irregular non-circular shape in a significant number of eyes with VMT. Consequently, the area of traction appears inaccurately described by its horizontal VMT diameter alone. As the area of traction is important for therapeutic recommendation, our results emphasize the need for a more precise description of the area of traction in eyes with VMT.
Entities:
Keywords:
Area of traction; Horizontal diameter; Optical coherence tomography; Vitreomacular attachment; Vitreomacular traction (VMT); Vitreous attachment sites
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