Vitreomacular traction is an eye condition which occurs when the vitreous jelly inside the eye pulls or exerts a force on the macula. This tractional force generated by the adhesion of the jelly to the macula distorts the normal contour of the retina, resulting in blurred and /or distorted vision. Similar sympotms are also experienced in other conditions affecting the macula, such as age-related macular degeneration and epiretinal membrane.
The vitreous jelly is normally firmly attached to the retina. It becomes more watery and may eventually detach from the retina in a process known as posterior vitreous detachment and it is considered part of normal aging. However, if the vitreous jelly does not fully separate from the retina, leaving points of contact or adhesions, the remaining partially attached vitreous can pull and distort the macula, resulting in vitreomacular traction. The condition is easily diagnosed using high-resolution optical coherence tomography.
When the patient is asymptomatic from vitreomacular traction, observation and regular follow-up is recommended to monitor the condition. Some cases of vitreomacular traction syndrome resolve spontaneously. It is recommended that you check your vision at home regularing using an Amsler grid and look out any changes in vision or new symptoms.
If vitreomacular traction is associated with significant visual distortion, vitrectomy surgery is recommended. The same procedure is used to treat epiretinal membrane.
Vitrectomy – This is a delicate surgical procedure where the vitreous is removed from the eye to relieve the pulling or traction on the macula. A vitrectomy is usually performed with sedation under monitored local anesthesia. In most cases, patients experience a significant improvement in vision. Your ophthalmologist will discuss the benefits and risks of surgery and provide instructions regarding postoperative care.
Ocriplasmin – This is a an intravitreal therapy which is administered as a single injection into the eye (marketed as Jetrea®). The drug works in select cases by dissolving the adhesion between the vitreous and the macula, thereby relieving the traction.