How much vision is restored after surgery for VMT generally depends on the severity of the condition and how long it was present before surgery. Will my vision improve after surgery for VMT? If used, the gas slowly disappears over days to weeks. Sometimes the eye is filled with a gas at the end of surgery to help with healing. During the surgery, microscopic instruments are inserted into the eye to release all adhesions of the gel to the macula, to remove the vitreous gel, and to peel away any residual membranes on the surface of the macula that may also be contributing to distortion of the vision. This painless surgery is performed as an outpatient procedure (no overnight hospital stay) under local anesthesia with sedation. More commonly, as the gel shrinks the vision worsens and a surgery called a vitrectomy will be recommended to release the traction. Sometimes as the vitreous gel continues to shrink, its adhesion to the macula will release and the VMT will resolve without treatment. Follow up examinations are necessary to monitor for worsening of the condition. In cases of VMT where the vision is unaffected, no treatment may be necessary.
Sometimes, VMT worsens and the increased traction results in blurred or distorted central vision. VMT may cause no symptoms at all in its mildest forms. An OCT image of VMT before surgery, showing upward traction on the macula from elevation of the vitreous gel (arrows). Specialized tests such as a photographic assessment of the retinal blood flow after injection of an intravenous dye called a fluorescein angiogram and a computerized optical scan of the retina called an OCT can help in making the diagnosis and in determining the severity of VMT. How is VMT diagnosed?Ī careful retinal examination can reveal signs of VMT, including distortion and elevation of the retina and fluid accumulation within areas of stretched retina. VMT only occurs when there is an abnormally tight adhesion between the shrinking gel and the macula. The vitreous gel shrinks and pulls away from the macula at different rates in each person, but it occurs in everyone with time. Información en español en el sitio web de ASRS What causes VMT? Learn more about vitreomacular traction (VMT) at ASRS Fluorescein angiogram image in a patient with VMT, showing distortion of the retinal blood vessels and white “clouds” indicating fluid accumulation in areas of traction, especially in the center and upper portion of the image. This pulling and distortion of the normal macular structure is called vitreomacular traction (VMT). Sometimes as the vitreous pulls away from the macula, it remains partially stuck and pulls on the surface. As we grow older the thick vitreous gel that fills the eye shrinks and pulls away from the macula. It is the macula that gives us the vision we use to read and to do detailed visual tasks. The macula is the most sensitive part of the retina. The macula is the small area at the center of the retina, which is the thin tissue that lines the inside of the back of the eye. Vitreomacular Traction What is vitreomacular traction? Tantalum Marker Placement for Proton Beam Radiotherapy.Presumed Ocular Histoplasmosis Syndrome.
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