Vitreomacular adhesion a risk factor and inducing PVD a treatment option in patients with age related macular degeneration

Authors : Krishna Nagaradh, Prarthana Gokarn

DOI : 10.18231/j.ijceo.2019.118

Volume : 5

Issue : 4

Year : 2019

Page No : 501-507

Purpose: To compare the state of posterior vitreous in the aetiology of exudative age related macular
degeneration (wet AMD) with non-exudative age related macular degeneration (dry AMD) and controls.
Materials and Methods: We did a Prospective comparative study of 200 eyes of patients aged more
than 65 years with Spectral domain OCT and ultrasonography over a period of one year. All subjects
underwent a detailed history, physical examination and comprehensive ocular examination. Other ocular
conditions like diabetic retinopathy, macular pucker, macular hole, inflammatory diseases, myopia of more
than 2D and previous ocular surgeries are excluded from the study. Eyes with evidence of neo vascular
AMD confirmed by FFA and ICG were included in group 1. Eyes with pigmentary changes at macula or
drusens were included in group 2 and eyes without any changes are included in group 3. These patients
were followed up for a duration of 6 months to see the progression at vitreomacular interface.
Results: In the present study, there is a significantly higher prevalence of VMA in patients with choroidal
neovascularisation in comparison to eyes with dry AMD and controls. More specifically the attachment site
of vitreous to the macula corresponds to the location of choroidal neovascularisation further suggesting the
relationship (95%). Patients treated with vitrectomy and anti VEGF for associated VMT showed favourable
results in terms of recurrence, visual acuity and number of anti VEGF injections. Also patients with VMA
and CNVM needed more frequent injections in comparison to patients with no VMA.
Conclusion: Persistent attachment of the posterior vitreous cortex to the macula is another risk factor for
the development and progression of exudative AMD. Inducing PVD could be a treatment option.

Keywords: Vitreo macular interface, Neovascular membrane, Age related macular degeneration, Optical coherence tomography,
Induction of PVD.

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