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J Ophthalmol. 2015;2015:809640. doi: 10.1155/2015/809640. Epub 2015 Mar 3.

A review of current management of vitreomacular traction and macular hole.

Author information

1
Clínica Universidad de Navarra, Avenida de Pío XII 36, 31008 Pamplona, Spain.
2
Hospital Vall d'Hebron, Passeig de la Vall d'Hebron, 119-129, 08035 Barcelona, Spain.
3
Hospital Universitario de Albacete, Avenida de Almansa, s/n, 02006 Albacete, Spain.
4
Hospital de Bellvitge, C/Feixa Llarga, s/n, L'Hospitalet de Llobregat, 08907 Barcelona, Spain.
5
Complejo Hospitalario Universitario Insular Materno Infantil de Gran Canaria, Avenida Marítima del Sur, s/n, 35016 Las Palmas de Gran Canaria, Spain.
6
Hospital Universitario Ramon y Cajal Carretera de Colmenar km 9, 28034 Madrid, Spain ; Vissum Madrid, Santa Hortensia 58, 28002 Madrid, Spain.

Abstract

The paper presents a review of the sequence of events of posterior vitreous detachment (PVD), vitreomacular adhesion (VMA), vitreomacular traction (VMT), and macular hole (MH) from their pathophysiological aspects, clinical features, diagnostic implications, and current management strategies. A treatment algorithm to be used in clinical practice in patients with VMA, VMT, and MH based on the presence of symptoms, visual acuity, associated epiretinal membrane, and width of the vitreous attachment is presented. Observation, pharmacologic vitreolysis with ocriplasmin, and surgical treatment are positioned as treatment options in the different steps of the therapeutic algorithm, with clear indications of the paths to be followed according to the initial presenting manifestations and the patient's clinical course.

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