Introduction
Represents the 2 starting phases of the vitreomacular interface diseases that are not normal age-related changes.
- Pulls plane of detachment inwards and anteriorly in eye
- Pulls the fovea above plane of the macula
- Ocular saccades and movements lead to an increasingly more detached vitreous, dynamic traction and progress to PVD
Epidemiology of vitreomacular interface diseases:
- Usually idiopathic and affects 3 in 1000 people, mostly commonly females in the 6th and 7th decades of life.
- Other causes include trauma, high myopia, chronic macula oedema
- Is typically unilateral
Dead Giveaways
Persistent Vitreomacular adhesion
The perifoveal region will show detachment
The attachment is at or within 3 mm of the macula
No distortion of foveal contour of underlying tissue, and vitreous appears to be tangential
Displays a largely tangential adhesion
Vitreomacular Traction:
Can either be focal (<1500 microns) or broad (>1500 microns)
Distortion may be present on the foveal surface. May be present on foveal surface. May have intraretinal abnormalities/elevations of the fovea above the RPE
Persistent traction leads to the distortion of the foveal surface
1. Shows foveoschisis and pseudocysts, with underlying RPE being raised by tractional forces. 2. Shows the distortion and elevation of the fovea. 3. Shows distortion of the macular surface and some drusenoid changes.