Location, direction of vitreomacular traction correspond with origin of CNV

Br J Ophthalmol. 2011;95:1415-1418

There may be a high prevalence of type 3 lesions in eyes with vitreomacular adhesions, and location of adhesion may correspond completely with the location of choroidal neovascularization, a study found.

Thirty eyes of 25 consecutive patients with vitreomacular adhesion and exudative age-related macular degeneration underwent scans using Cirrus (Carl Zeiss Meditec) and Spectralis (Heidelberg Engineering) optical coherence tomography.

"We were able to show that the location and the direction of the traction forces visualized by high-technology OCT and 3-D OCT correspond in 100% with the origin of the CNV," the study authors said.

Type 3 lesions were found in 50% of eyes, while 46.7% had occult lesions and 3.3% had predominantly classic lesions. Localization of the adhesion corresponded in all eyes with area of CNV; in 73.3%, vitreomacular traction directed toward the CNV, and in 83.3%, it directed toward the optic disc.

Intravitreal anti-VEGFs did not influence vitreomacular adhesion or traction in 77% of eyes. Only 10% exhibited posterior vitreous detachment, and 13.3% showed an increase in traction or the conversion of adhesion to traction. This suggests that adhesion may be more important in the pathogenesis of neovascular AMD, while traction may develop later and influence further disease progression, the study authors said.