Clinical course of vitreomacular adhesion managed by initial observation

Vishak J. John, Harry W. Flynn, William E. Smiddy, Adam Carver, Robert Leonard, Homayoun Tabandeh, David S. Boyer

Research output: Contribution to journalArticlepeer-review

55 Scopus citations


PURPOSE:: The purpose of the study was to investigate the clinical course of patients with idiopathic vitreomacular adhesion (VMA). METHODS:: A noncomparative case series of patients who had clinical symptoms and spectral-domain optical coherence tomography findings consistent with VMA. The VMA was graded based on the optical coherence tomography findings at initial and follow-up examinations. Grade 1 was incomplete cortical vitreous separation with attachment at the fovea, Grade 2 was the Grade 1 findings and any intraretinal cysts or clefts, and Grade 3 was the Grade 2 findings and the presence of subretinal fluid. RESULTS:: One hundred and six eyes of 81 patients were identified as having VMA by spectral-domain optical coherence tomography at 3 retina clinics. The mean age was 73 years and the mean time of follow-up was 23 months. Forty-three eyes (41%) had Grade 1 VMA, 56 eyes (52%) had Grade 2 VMA, and 7 eyes (7%) had Grade 3 VMA. By the last follow-up, spontaneous release of VMA occurred in 34 eyes (32%), and pars plana vitrectomy was performed in 5 eyes (4.7%). Mean best-corrected visual acuity was 0.269 logarithm of the minimum angle of resolution or 20/37 at baseline (range, 20/20-20/200) and logarithm of the minimum angle of resolution 0.251 or 20/35 at the last examination (range, 20/20-20/400). CONCLUSION:: In this selected patient cohort with mild symptoms, the clinical course of patients with VMA managed by initial observation was generally favorable.

Original languageEnglish (US)
Pages (from-to)442-446
Number of pages5
Issue number3
StatePublished - Mar 2014


  • macular hole
  • microplasmin
  • vitreofoveal adhesion
  • vitreomacular traction

ASJC Scopus subject areas

  • Ophthalmology


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