Vitreomacular Traction Syndrome

Color photograph of the right fundus demonstrates a pseudohole. Intraretinal cystic changes caused by the vitreoretinal traction become apparent in the red-free image. OCT scan demonstrates the incomplete vitreous separation with vitreous attachment to the perifoveal retina. 

  • Incomplete vitreous separation with persistent vitreous attachment to the macula
  • May also lead to the formation of epiretinal membrane, macular puckering, cystoid macular edema with or without fluorescein leakage, tractional macular detachment and frank macular hole
  • Spontaneous resolution has been reported

Clinical features:

  • Symptoms:
    • May be asymptomatic
    • Decreased vision
    • Metamorphopsia in the presence of macular pucker
  • Signs:
    • Dull foveal reflex
    • Wrinkling of the retina
    • Stretching or corrugating appearance of the retinal vessels
    • Pseudohole

Management:

  • Observation if symptoms have been stable
  • Vitrectomy with membrane peeling in patients with worsening vision of less than 20/50 and significant metamorphopsia