Vitreomacular Traction Syndrome - Spontaneous Release

Vitreomacular traction syndrome is an eye condition that involves the vitreous, the gel that fills the eye. Usually with age, the gel will liquefy and detach completely from the retina. This is called a posterior vitreous detachment (PVD). However, there are cases where the gel does not liquefy completely resulting in vitreomacular traction syndrome. Because the macula is still attached, fluid can collect under the retina and cause cell damage and death. This is a 65-year-old patient that was seen for a decrease in her right eye vision. Her visual acuity was 20/50 in the right eye and 20/20 in the left. On her fundus exam, she had vitreomacular traction in the right eye. Her 2012 optical coherence tomography (OCT) scans reflects this (red arrow). Green arrows point to the vitreous that is tugging on the macula. Over two years of observation the traction did not release and her vision remained at 20/50. Therefore, in July of 2014 she had vitrectomy, membrane peeling of the right macula. From 2012 to 2014 she developed vitreomacular traction in the left eye as well (green arrows show vitreous tugging, yellow arrow shows vitreomacular contour distortion), but in this case, under observation, the gel in her left eye released spontaneously (OCT from 2017). The blue arrow points to cysts made from traction that will flatten over time. Treatment for this condition usually involves a period of observation looking for spontaneous release first. If release does not occur, then vitrectomy to separate the vitreous from the retina and optic disk is usually successful. At her most recent follow-up her visual acuity is 20/40 in her right eye and 20/50 in her left.