Table 2.
Clinical features, SD-OCT findings and new onsets of signs/symptoms among patients with initial vitreomacular adhesion that progressed into vision-threatening sequelae.
| Case number | age range (yrs) | Sex | Eye | SD-OCT Findings of VMAa | Cx (VMAng)b | Management | VA (Pre~post-op) | New Onset Signs/Symptoms |
|---|---|---|---|---|---|---|---|---|
| 01 | 70~79 | 1 | OD | partial detachment temporal to fovea | FTMHc (82.9°) | VT+Peel | 2.0~1.3d | N. fundus/VA↓ |
| 02 | 50~59 | 2 | OD | partial detachment temporal to fovea | MP (1.2°) | VT+Peel | 0.3~0.2 | N. fundus/floaters |
| 03 | 40~49 | 2 | OD | partial detachment temporal to fovea | RD (8.0°) | VT+SB+SO | 1.3~0.7 | LD & RB/flashes |
| 04 | 60~69 | 2 | OS | V-shaped | FTMHc (25.0°) | VT+Peel+SB | 0.7~0.0d | Retina hole/distortion |
| 05 | 60~69 | 2 | OS | V-shaped | FTMHc (14.9°) | VT+Peel+SB+SO | 0.8~1.3d | RB/VA↓ |
| 06 | 60~69 | 2 | OS | V-shaped | FTMHc (25.0°) | VT+Peel | 0.8~0.4d | N. fundus/VA↓ |
| 07 | 40~49 | 1 | OD | V-shaped | FTMHc (19.3°) | VT+Peel | 1.0~2.0d | foveoschisis/VA↓ |
| 08 | 40~49 | 1 | OS | V-shaped | FTMHc (2.8°) | VT+Peel | 0.7~0.2d | N. fundus/Distortion |
| 09 | 20~29 | 1 | OD | V-shaped | RD (6.2°) | VT+SB+SO | 1.3~2.0 | LD & RB/VA↓ |
| 10 | 30~39 | 1 | OS | partial detachment nasal to fovea | FTMHc (13.2°) | VT+Peel | 1.3~0.7d | foveoschisis/VA↓ |
| 11 | 70~79 | 2 | OS | V-shaped | VTM (9.2°) | VT+Peel | 0.3~0.2 | Macula cyst/VA↓ |
| 12 | 70~79 | 1 | OD | V-shaped | FTMHc (10.5°) | VT+Peel | 1.3~0.5d | N. fundus/flashes |
aSD-OCT findings of vitreomacular adhesion (VMA) which was divided into 2 types, namely V-shaped VMA (see Case 4 in Fig. 2a) as well as nasal or temporal perifoveal vitreous detachment with respective temporal or nasal VMA (see Case 2 in Fig. 1vs).
bThe VMAng was directly measured (underlined and bolded for FTMH; e.g. Case 4: 25.0°; Please also refer to the section Measurement of the vitreomacular angle of the Methods) by the On-Screen Protractor Program (Minimum JRE version 1.7, GNU GPL v3).
cAfter above vitreoretinal surgeries that were respectively given to 8 cases of FTMH, there were 5 cases (62.5%: Case 1, 4, 6, 8 and 12) of closed hole, 1 case (Case 10) of sealed hole and 2 cases (Case 5 and 7) of unclosed hole. Postoperatively, there were 5 cases (62.5%: Case 1, 5, 7, 8 and 10) with macular photoreceptor inner segment-outer segment (IS-OS) disruption and 3 cases (Case 4, 6 and 12) without IS-OS disruption.
dFurthermore, the pre-operative best corrected visual acuities (BCVAs; LogMAR) were, though not significantly, improved from 1.1±0.4 to 0.8±0.7. Distortion is defined as distorted image.
Abbreviations: SD-OCT spectrum domain optical coherence tomography; Cx complication; yrs years; VMAng vitreomacular angle; VA (Pre~post-op); BCVA (Pre~post-op: pre-~post-operative visit); LogMAR logarithm of the minimum angle of resolution; FTMH full-thickness macular hole; MP macular pucker; RD retinal detachment; VMT vitreomacular traction; LD lattice degeneration; RB retinal break; VT pars plana vitrectomy; peel, internal limiting membrane peeling; SB scleral buckle; SO silicon oil tamponade.