Vitreomacular traction syndrome 05/04/2013

Under normal conditions, the vitreous humour adheres to the retina via a fine membrane called the posterior hyaloid. When this separates from the retina, it results in vitreous detachment. Sometimes there are areas of the retina that are so strongly attached to the posterior hyaloid they remain anchored in spite of the detachment of the rest of the vitreous, leading to vitreoretinal traction. When traction occurs in the macula (the area of the retina responsible for most vision), it's called the vitreomacular traction syndrome.

This pulling on the macula can result in an accumulation of liquid (cystoid macular oedema) or the layers of the retina separating (macular retinal tear) or even the formation of holes in the macula, entailing loss of vision.

Symptoms

Sometimes the symptoms are very difficult to detect and this pathology can go unnoticed. In these cases, although suffering from vitreomacular traction syndrome, if the patient still has relatively good eyesight and no symptoms of visual distortion, surgery is not recommended but the condition is monitored to see how it develops.

When symptoms are detected, patients normally suffer from loss of central vision and metamorphopsia (when straight lines are seen as wavy). Such cases must undergo surgery to avoid irreversible changes in the retina.

Treatment 

Eliminating traction via vitrectomy avoids the loss of sight or restores it.

Pharmacologic vitreolysis has recently become available (intravitreal injections of drugs that separate the posterior hyaloid from the retina) to stop the illness from advancing in early cases and avoid surgery in some cases.

At the Institut de la Màcula we are developing keyhole vitreal retinal surgical techniques that allow us to achieve the best anatomical and functional results in retinal problems requiring surgery.