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Comparison of the horizontal diameter to a modeled area of traction in eyes with vitreomacular traction: is the diameter close enough to the truth?

  • Retinal Disorders
  • Published:
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Abstract

Purpose

In daily practice, vitreomacular traction (VMT) is described by the horizontal diameter of its attachment site implying a regular round shape of VMT. We investigated the deviation from this circular area of vitreous traction in patients with VMT.

Methods

A retrospective analysis of optical coherence tomography (OCT) scans was performed. The area of vitreomacular attachment was determined using six radial OCT scans (Ameasured). The assumed circular area of traction was calculated based on measuring the maximal horizontal diameter for comparison (Acircular).

Results

Thirty-seven eyes of 37 patients with pure VMT were included. Patients’ mean age was 72.8 ± 8.2 years. Mean horizontal VMT diameter was 400.8 ± 230.5 μm (median 361 μm; range 44–991 μm). While there was no difference between mean areas of traction for Acircular and Ameasured (P = 0.93), the individual difference (|Acircular − Ameasured|) was 0.042 (± 0.044) mm2 in mean or relative 73.0% (± 135.8%). A difference of ≥ 30% of Ameasured to Acircular was found in 16 eyes (43.2%) and ≥ 100% in 7 eyes (18.9%), respectively.

Conclusion

Vitreous attachment sites possess an irregular non-circular shape in a significant number of eyes with VMT. Consequently, the area of traction appears inaccurately described by its horizontal VMT diameter alone. As the area of traction is important for therapeutic recommendation, our results emphasize the need for a more precise description of the area of traction in eyes with VMT.

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Author information

Authors and Affiliations

  1. Department of Ophthalmology, Philipps-University Marburg, Baldingerstraße, 35043, Marburg, Germany

    Christoph Paul

  2. Department of Ophthalmology, University Medical Center Goettingen, Goettingen, Germany

    P. Krug & T. Bertelmann

  3. Institute of Medical Biometry and Epidemiology, Philipps-University Marburg, Marburg, Germany

    H. H. Müller

  4. Department of Ophthalmology, Sankt Gertrauden-Krankenhaus, Berlin, Germany

    J. Wachtlin

  5. The Brandenburg Medical School Theodor Fontane, Neuruppin, Germany

    J. Wachtlin

  6. Department of Ophthalmology, Feldkirch State Hospital, Feldkirch, Austria

    S. Mennel

  7. Department of Ophthalmology, University of Bonn, Bonn, Germany

    S. Müller & S. Schmitz-Valckenberg

  8. ARTEMIS Eye Clinic, Dillenburg, Germany

    T. Bertelmann

  9. Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany

    R. G. Schumann

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  1. Christoph Paul
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Corresponding author

Correspondence to Christoph Paul.

Ethics declarations

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (ethics committee of the medical department, Philipps-University Marburg, Germany) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required. This article does not contain any studies with animals performed by any of the authors.

Conflict of interest

The authors declare that they have no conflict of interest.

Electronic supplementary material

Supplementary Figure 1

Exemplary measurement of Ameasured. The vertical OCT scan is selected (A) and the upper border of the vitreomacular attachment marked (green line, B, right side). This marked is transferred to the en face projection (blue x, B, left side). This stepped is repeated for all scans (C). Finally, the border marks in the en face projection (blue x, D) are used to measure the enclosed area of traction (yellow cirle, D). (JPG 2833 kb)

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Paul, C., Krug, P., Müller, H.H. et al. Comparison of the horizontal diameter to a modeled area of traction in eyes with vitreomacular traction: is the diameter close enough to the truth?. Graefes Arch Clin Exp Ophthalmol 256, 1817–1822 (2018). https://doi.org/10.1007/s00417-018-4055-0

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  • DOI: https://doi.org/10.1007/s00417-018-4055-0

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