by Dr. Dale Brown Vitreoretinal Specialist at VisionAmerica The first image below shows significant vitreomacular traction. Fortunately, this patient maintained an acuity of 20/40 and was fairly asymptomatic. As a result, the decision was made to observe. Waiting to perform surgery does not affect overall prognosis/visual potential in most cases and also gives the VMT a chance to spontaneously resolve. The second image demonstrates why it is important to be patient and watch some of these cases. Six months later the patient had resolution of the VMT with residual lamellar changes but the patient was still 20/40 and doing well.
Surgical intervention is definitely an option and I tend to base the decision on the patient's symptoms. Similar to cataracts, just because you have a cataract doesn't mean you need surgery. Just because you have VMT doesn't mean surgery but if the patient is symptomatic with reduced acuity and/or metamorphopsia then I definitely discuss surgery as an option.
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August 2019
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