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PREDICTIVE FACTORS OF VISUAL OUTCOME FOR VITREOMACULAR TRACTION SYNDROME AFTER VITRECTOMY

Purpose: To assess the long-term functional and anatomical outcomes for vitreomacular traction syndrome (VMT) after vitrectomy and to analyze the predictive factors regarding visual outcome. Methods: A retrospective, consecutive case series of 22 eyes in 22 patients with VMT who underwent vitrectomy to relieve macular edema were studied. Eyes were classified into two groups according to the diameter of vitreomacular adhesion based on spectral domain optical coherence tomography: Group 1 (14 eyes) focal attachment ⩽1,500 &mgr;m; and Group 2 (eight eyes) broad attachment >1,500 &mgr;m. Results: Mean postoperative follow-up was 25.4 months (range, 6–68). The preoperative mean logarithm of the minimal angle of resolution visual acuity was 0.73 (20/107), which significantly improved to 0.49 (20/62) postoperatively (P < 0.01). Seventeen eyes (77%) had Snellen visual acuity improvement ≧ two lines, and nine eyes had improvement ≧ three lines. The improvement of visual acuity was significantly better in Group 1 than in Group 2 (2.7 lines vs. 0.8 lines) (P = 0.03). The preoperative mean central macular thickness was 563 &mgr;m ± 176 &mgr;m, which significantly improved to 298 &mgr;m ± 69 &mgr;m postoperatively (P < 0.01). In multivariate analysis, better final visual acuity was significantly associated with Group 1 VMT (P < 0.01) and with shorter symptom duration (P < 0.01). Greater improvement of visual acuity was also significantly associated with younger age of patients (P = 0.02) and with Group 1 VMT (P < 0.01). In linear regression analysis, patients with longer symptom duration had worse final visual acuity (&bgr; = 0.02) and patients of younger age had greater visual acuity improvement (&bgr; = 0.008). Conclusion: Most patients of VMT gained significant functional and anatomical improvements after vitrectomy. Group 1 optical coherence tomography pattern, shorter symptom duration, and younger age are significant predictive factors of better visual outcome.