Long-term study of vitreomacular traction syndrome: Optical coherence tomographic patterns and surgical results

Purpose: To investigate the optical coherence tomographic (OCT) patterns and long-term surgical outcomes of patients with vitreomacular traction syndrome (VMT). Methods: From May 2002 to April 2008, patients with OCT-confirmed VMT who underwent vitrectomy were retrospectively reviewed. Complete pre- and postoperative ophthalmic and OCT examinations were recorded. All cases were followed for at least 2 years. The OCT patterns of VMT were classified into two groups: Group 1, V-shaped macular traction (1A: without macular detachment, 1B: with macular detachment); Group 2, U-shaped macular traction (2A: without macular detachment, 2B: with macular detachment). Multiple linear regression analysis of selective factors was performed to investigate the main determinants of visual improvement. Results: Twenty-five eyes of 25 consecutive patients were enrolled (8 in 1A, 6 in 1B, 6 in 2A, 5 in 2B). One patient in 2A progressed to 2B within 4 months. After surgery, 18 patients regained normal foveal contour accompanied by visual improvement; three patients had persistent cystoid macular edema throughout the follow-up period and a worsened visual acuity; the other four had an unchanged visual status despite improved foveal configuration. The mean ± standard deviation thickness in the central macular area was 632.0 ± 228.3 μm preoperatively and347.1 ± 126.1 μm postoperatively (p < 0.001). Multiple lineal regression analysis revealed that U-shape VMT (p = 0.005), preoperative foveal detachment (p = 0.011) and preoperative visual acuity (p = 0.035) might correlate with final vision. Conclusion: OCT may detect two major configurations of VMT. Vitrectomy is an effective treatment, but U-shaped macular traction, preoperative foveal detachment and poor preoperative vision show unfavorable visual prognosis.