A retrospective cohort study in patients with tractional diseases of the vitreomacular interface (ReCoVit)

To assess how vitreomacular adhesion (VMA), vitreomacular traction (VMT), and macular holes (MH) evolve, and to assess visual acuity outcomes associated with different management strategies for each subgroup.

Retrospective, single-center, observational study of 400 patients (556 eyes) who presented with optical coherence tomography (OCT) findings related to tractional diseases of the vitreomacular interface (187 with bilateral disease). The outcomes measured include prevalence of symptoms, rates of disease stabilization, spontaneous resolution, and disease progression necessitating surgical intervention. Size of VMA/VMT was not measured.

Vision loss and metamorphopsia were the leading causes for referral. Patients were followed for a mean of 10.9 months (median 6.9 months). Spontaneous resolution occurred in 22.7 % (46/203) of eyes with VMT and in 7.3 % (9/124) of eyes with VMA (P < .001). In the former group, 34.1 % (14 eyes) showed improved visual acuity (P = .001). During follow-up, 11.3 % (14/124) of eyes with VMA showed disease progression; six (4.8 %) developed a macular hole. Eleven of the 203 eyes with VMT (5.4 %) developed a macular hole; 52 of 203 eyes with VMT (25.6 %) had disease progression that resulted in patients opting for pars plana vitrectomy (PPV). Of the eyes with VMA, 4.8 % (6/124) had disease progression resulting in patients opting for PPV.

Better visual acuity outcomes were found in eyes with spontaneous resolution compared to the other groups. Spontaneous resolution of VMT and VMA was rare, whereas disease progression resulting in PPV was more common.