Three-dimensional evaluation of vitreomacular traction and epiretinal membrane using spectral-domain optical coherence tomography.

PURPOSE To delineate the 3-dimensional (3-D) relationship in vitreomacular traction (VMT) and idiopathic epiretinal membrane (ERM). DESIGN Observational case series. METHODS Forty-eight evaluable eyes of 35 patients with VMT or idiopathic ERM were investigated with spectral-domain (SD) optical coherence tomography (OCT). VMT was defined as focal if the diameter of the vitreous attachment was 1500 microm or less and broad if it was more than 1500 microm. The 3-D OCT representation of vitreomacular interface abnormalities was evaluated. RESULTS Focal VMT was seen in five eyes. Broad VMT was seen in seven eyes. Of these 12 eyes, concurrent ERMs under the detached vitreous were seen in 10 eyes and zones of hyperreflectivity affecting the adjacent detached posterior hyaloid face were seen in 11 eyes. Eyes with focal VMT showed a foveal cavitation, whereas eyes with broad VMT had more widespread cystoid macular edema. Idiopathic ERM was seen in 36 eyes; 30 had complete posterior vitreous detachment (PVD), five had partial PVD associated with attached posterior hyaloid at some peripheral portion of the ERM, and one had no PVD. CONCLUSIONS The SD OCT with 3-D image reconstruction provided unprecedented visualization of VMT and idiopathic ERM. The vitreous attachment to the macula can be subclassified into two subgroups, each having specific induced alterations in retinal anatomy. Most of the eyes with VMT had concurrent ERM, whereas several eyes with idiopathic ERM had attachment of the vitreous to some portion of the ERM, which suggests there is significant overlap between VMT and idiopathic ERM.

[1]  Ali Erginay,et al.  Diagnosis of macular pseudoholes and lamellar macular holes by optical coherence tomography. , 2004, American journal of ophthalmology.

[2]  H. Sachs,et al.  Macular function and morphology after peeling of idiopathic epiretinal membrane with and without the assistance of indocyanine green , 2005, British Journal of Ophthalmology.

[3]  J. Duker,et al.  Three-dimensional retinal imaging with high-speed ultrahigh-resolution optical coherence tomography. , 2005, Ophthalmology.

[4]  J. Sebag.  Oval defect in detached posterior hyaloid membrane in idiopathic preretinal macular fibrosis. , 1995, American journal of ophthalmology.

[5]  N. Jaffe.  Vitreous traction at the posterior pole of the fundus due to alterations in the vitreous posterior. , 1967, Transactions - American Academy of Ophthalmology and Otolaryngology. American Academy of Ophthalmology and Otolaryngology.

[6]  J. Clarkson,et al.  A HISTOPATHOLOGIC REVIEW OF 168 CASES OF PRERETINAL MEMBRANE , 1977, American journal of ophthalmology.

[7]  W. Green,et al.  Ultrastructural studies of vitreomacular traction syndrome. , 1989, American journal of ophthalmology.

[8]  J. Donald M. Gass.  Stereoscopic atlas of macular diseases , 1977 .

[9]  Richard F Spaide,et al.  Correlation of vitreous attachment and foveal deformation in early macular hole states. , 2002, American journal of ophthalmology.

[10]  J. Schuman,et al.  Optical coherence tomography. , 2000, Science.

[11]  S. Yoneya,et al.  COMPARISON OF EPIRETINAL MEMBRANES OF DIFFERING PATHOGENESIS USING OPTICAL COHERENCE TOMOGRAPHY , 2004, Retina.

[12]  S. Kishi,et al.  Vitreous cortex remnants at the fovea after spontaneous vitreous detachment , 1986, International Ophthalmology.

[13]  J. Larsson.  Vitrectomy in vitreomacular traction syndrome evaluated by ocular coherence tomography (OCT) retinal mapping. , 2004, Acta ophthalmologica Scandinavica.

[14]  S. deBustros,et al.  Vitrectomy for macular traction caused by incomplete vitreous separation. , 1988, Archives of ophthalmology.

[15]  T. Yatagai,et al.  Three-dimensional imaging of macular holes with high-speed optical coherence tomography. , 2007, Ophthalmology.

[16]  D. M. Gass,et al.  Stereoscopic Atlas of Macular Diseases: Diagnosis and Treatment , 1987 .

[17]  M. Wojtkowski,et al.  Real-time in vivo imaging by high-speed spectral optical coherence tomography. , 2003, Optics letters.

[18]  E Reichel,et al.  Characterization of epiretinal membranes using optical coherence tomography. , 1996, Ophthalmology.

[19]  U. Schmidt-Erfurth,et al.  Three-dimensional ultrahigh-resolution optical coherence tomography of macular diseases. , 2005, Investigative ophthalmology & visual science.

[20]  S. Mennel,et al.  Spontaneous separation of epiretinal membrane in young subjects: personal observations and review of the literature , 2004, Graefe's Archive for Clinical and Experimental Ophthalmology.

[21]  J. Duker,et al.  Visual prognosis correlated with the presence of internal-limiting membrane in histopathologic specimens obtained from epiretinal membrane surgery. , 1990, Ophthalmology (Rochester, Minn.).

[22]  Y. Miyake,et al.  Three-dimensional optical coherence tomography of vitreomacular traction syndrome before and after vitrectomy. , 2000, Retina.

[23]  Maciej Wojtkowski,et al.  High-definition and 3-dimensional imaging of macular pathologies with high-speed ultrahigh-resolution optical coherence tomography. , 2006, Ophthalmology.

[24]  P. Gastaud,et al.  [Ultrastructural findings of epimacular membrane and detached posterior hyaloid in vitreomacular traction syndrome]. , 2000, Journal francais d'ophtalmologie.

[25]  E. Postel,et al.  DIAGNOSIS OF VITREORETINAL ADHESIONS IN MACULAR DISEASE WITH OPTICAL COHERENCE TOMOGRAPHY , 2000, Retina.

[26]  S. Kishi,et al.  Tomographic features and surgical outcomes of vitreomacular traction syndrome. , 2005, American journal of ophthalmology.

[27]  T. Hida,et al.  ULTRASTRUCTURAL AND IMMUNOHISTOCHEMICAL FINDINGS IN FIVE PATIENTS WITH VITREOMACULAR TRACTION SYNDROME , 2000, Retina.

[28]  Teresa C. Chen,et al.  In vivo human retinal imaging by ultrahigh-speed spectral domain optical coherence tomography. , 2004, Optics letters.

[29]  A Erginay,et al.  Optical coherence tomography of idiopathic macular epiretinal membranes before and after surgery. , 2000, American journal of ophthalmology.

[30]  E. Uchino,et al.  Postsurgical evaluation of idiopathic vitreomacular traction syndrome by optical coherence tomography. , 2001, American journal of ophthalmology.

[31]  Mark W. Johnson.  Perifoveal vitreous detachment and its macular complications. , 2006, Transactions of the American Ophthalmological Society.

[32]  J. Folk,et al.  EPIRETINAL MACULAR MEMBRANES IN EYES WITH ATTACHED POSTERIOR CORTICAL VITREOUS , 1996, Retina.

[33]  A. Kampik,et al.  Epiretinal pathology of vitreomacular traction syndrome , 2002, The British journal of ophthalmology.

[34]  W. Green,et al.  Idiopathic Epiretinal Membranes: Ultrastructural Characteristics and Clinicopathologic Correlation , 1989, Ophthalmology.

[35]  W. Green,et al.  Epiretinal and Vitreous Membranes: Comparative Study of 56 Cases , 2005, Archives of ophthalmology.

[36]  Mark W. Johnson,et al.  Tractional cystoid macular edema: a subtle variant of the vitreomacular traction syndrome. , 2005, American journal of ophthalmology.

[37]  R Brancato,et al.  Optical Coherence Tomography in Idiopathic Epiretinal Macular Membrane Surgery , 1999, European journal of ophthalmology.

[38]  R. Forte,et al.  Visualization of vitreomacular tractions with en face optical coherence tomography , 2007, Eye.

[39]  M. Kondo,et al.  Function and morphology of macula before and after removal of idiopathic epiretinal membrane. , 2003, Investigative ophthalmology & visual science.