TY - JOUR
T1 - Mechanistic Insights into the Pathogenesis of Proliferative and Nonproliferative Vitreomacular Traction
AU - ITO, Y. O.K.O.
AU - TAKATSUDO, Y. U.K.I.
AU - GEHLBACH, PETER L.
AU - MORI, KEISUKE
N1 - Funding Information:
ALL AUTHORS HAVE COMPLETED AND SUBMITTED THE ICMJE FORM FOR DISCLOSURE OF POTENTIAL CONFLICTS OF INTEREST and none were reported. Acknowledgments: The authors thank Junji Kanno of Saitama Medical University and Mayuka Tsukahara of the International University of Health and Welfare for help with the technical innovation of montaged imaging. Funding/Support: This research was supported in part by a grant-in-aid for scientific research (19K09998) from the Ministry of Education, Culture and Science in Japan, AMO Contracted Research Grant Program (AS2020A000025607) and a generous gift by Dr. Hiroaki Isono (KM). Research to Prevent Blindness, New York, New York, USA, and gifts by the J. Willard and Alice S. Marriott Foundation, the Gale Trust, Mr. Herb Ehlers, Mr. Bill Wilbur, Mr. and Mrs. Rajandre Shaw, Ms. Helen Nassif, Ms Mary Ellen Keck, Don and Maggie Feiner, Dick and Gretchen Nielsen, and Mr. Ronald Stiff (PLG). Financial Disclosures: All authors have no financial disclosure to report.
Funding Information:
Funding/Support: This research was supported in part by a grant-in-aid for scientific research (19K09998) from the Ministry of Education, Culture and Science in Japan, AMO Contracted Research Grant Program (AS2020A000025607) and a generous gift by Dr. Hiroaki Isono (KM). Research to Prevent Blindness, New York, New York, USA, and gifts by the J. Willard and Alice S. Marriott Foundation, the Gale Trust, Mr. Herb Ehlers, Mr. Bill Wilbur, Mr. and Mrs. Rajandre Shaw, Ms. Helen Nassif, Ms Mary Ellen Keck, Don and Maggie Feiner, Dick and Gretchen Nielsen, and Mr. Ronald Stiff (PLG).
Publisher Copyright:
© 2021 Elsevier Inc.
PY - 2022/6
Y1 - 2022/6
N2 - PURPOSE: To describe the vitreoretinal interface in vitreomacular traction (VMT) by using novel optical coherence tomography (OCT) methods; wide-angle montage, and pseudomotion OCT imaging systems. DESIGN: Observational case series. METHODS: Wide-angle montage OCT images of horizontal and vertical scans through the fovea were acquired in 50 eyes of 46 consecutive patients with VMT. Baseline fundus scans were obtained. These were followed by scans acquired with an eye-tracking system performed immediately after vertical and horizontal eye movements. Three scans were then superimposed to compare changes in the contour and position of the posterior vitreous. RESULTS: The subjects were classified as VMT with (“proliferative”; 48.0%) and without (“nonproliferative”; 52.0%) thickened posterior vitreous. Epiretinal membrane was observed in 26.9% of nonproliferative and 95.8% of proliferative VMT eyes (P = 3.6 × 10–7). No eye of proliferative and 57.7% of nonproliferative VMT eyes had wavy contoured posterior vitreous (P = 4.0 × 10–6). None with proliferative VMT, but 91.7% of nonproliferative VMT eyes, showed motion induced changes of posterior vitreous following eye movement (P = 2.0 × 10–8). The posterior vitreous detachment extended beyond the scanned area in 34.6% of nonproliferative and 8.3% of proliferative VMT eyes (P = .040). CONCLUSIONS: By dynamically evaluating the vitreoretinal interface of patients with VMT, the static contraction forces of a thickened posterior vitreous at the macula are implicated in proliferative VMT. This contractile force is not strongly implicated in the majority of VMT eyes with nontaut and more mobile vitreous (nonproliferative VMT). VMT and its associated complications are determined by at least 2 different pathophysiological mechanisms.
AB - PURPOSE: To describe the vitreoretinal interface in vitreomacular traction (VMT) by using novel optical coherence tomography (OCT) methods; wide-angle montage, and pseudomotion OCT imaging systems. DESIGN: Observational case series. METHODS: Wide-angle montage OCT images of horizontal and vertical scans through the fovea were acquired in 50 eyes of 46 consecutive patients with VMT. Baseline fundus scans were obtained. These were followed by scans acquired with an eye-tracking system performed immediately after vertical and horizontal eye movements. Three scans were then superimposed to compare changes in the contour and position of the posterior vitreous. RESULTS: The subjects were classified as VMT with (“proliferative”; 48.0%) and without (“nonproliferative”; 52.0%) thickened posterior vitreous. Epiretinal membrane was observed in 26.9% of nonproliferative and 95.8% of proliferative VMT eyes (P = 3.6 × 10–7). No eye of proliferative and 57.7% of nonproliferative VMT eyes had wavy contoured posterior vitreous (P = 4.0 × 10–6). None with proliferative VMT, but 91.7% of nonproliferative VMT eyes, showed motion induced changes of posterior vitreous following eye movement (P = 2.0 × 10–8). The posterior vitreous detachment extended beyond the scanned area in 34.6% of nonproliferative and 8.3% of proliferative VMT eyes (P = .040). CONCLUSIONS: By dynamically evaluating the vitreoretinal interface of patients with VMT, the static contraction forces of a thickened posterior vitreous at the macula are implicated in proliferative VMT. This contractile force is not strongly implicated in the majority of VMT eyes with nontaut and more mobile vitreous (nonproliferative VMT). VMT and its associated complications are determined by at least 2 different pathophysiological mechanisms.
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U2 - 10.1016/j.ajo.2021.11.026
DO - 10.1016/j.ajo.2021.11.026
M3 - Article
C2 - 34902326
AN - SCOPUS:85123833842
SN - 0002-9394
VL - 238
SP - 1
EP - 9
JO - American journal of ophthalmology
JF - American journal of ophthalmology
ER -