PREDICTIVE FACTORS OF SPONTANEOUS RELEASE OF VITREOMACULAR TRACTION: A Systematic Review and Meta-Analysis.

Abstract

PURPOSE:

To review predictive factors of spontaneous vitreomacular traction (VMT) release.

METHODS:

A systematic literature search was performed on Ovid MEDLINE, Embase, and Cochrane Library. Studies comparing spontaneously released VMT to persistent VMT were included. A meta-analysis was performed using a random effects model, and weighted mean difference, risk ratio (RR), and 95% confidence intervals (95% CI) were reported as appropriate.

RESULTS:

Of a search of 258 studies, 12 studies were included, from which 272 of 934 eyes (29%) underwent spontaneous release. Mean age was 70.0 years, 37.2% of patients were men, and mean follow-up was 22.0 months. Significant predictive factors for spontaneous release were smaller VMT diameter (n = 177; weighted mean difference = -212.48 µm, 95% CI = [-417.36, -7.60], P = 0.04), epiretinal membrane absence (n = 162; RR = 2.17, 95% CI = [1.18, 3.97], P = 0.01), and right eye involvement (n = 76; RR = 2.10, 95% CI = [1.14, 3.88], P = 0.02). Nonsignificant factors were age, initial best-corrected visual acuity, sex, ocular comorbidity, fellow-eye posterior vitreous detachment, previous intravitreal injection, and VMT classification with focal defined as ≤400 µm. Mean release time was 15.3 months (n = 212). Mean best-corrected visual acuity improved from 0.34 ± 0.21 (Snellen 20/44) to 0.20 ± 0.58 logMAR (Snellen 20/32) postrelease (n = 121).

CONCLUSION:

Smaller VMT diameter, epiretinal membrane absence, and right eye involvement may support spontaneous VMT release. If patients have tolerable symptoms, clinicians may consider observation in patients with these predictive factors.

• Authors: Anubhav Garg, Marko M Popovic, Milena Cioana, Brian G Ballios, Michael H Brent, Bernard Hurley, Peter J Kertes, Peng Yan
• Journal: Retina (Philadelphia, Pa.) (Retina) Vol. 42 Issue 7 Pg. 1219-1230 (07 01 2022) ISSN: 1539-2864 [Electronic] United States
• PMID: 35483036 (Publication Type: Journal Article, Meta-Analysis, Systematic Review)

Topics

• Aged
• Epiretinal Membrane
• Female
• Humans
• Intravitreal Injections
• Male
• Retrospective Studies
• Tomography, Optical Coherence
• Vision Disorders
• Visual Acuity
• Vitreous Detachment (diagnosis, drug therapy)