Vitreomacular Traction Syndrome

 

Vitreomacular traction syndrome occurs when the clear, jelly-like substance inside the eye, called the vitreous, ‘pulls’ on the macula, distorting its normal shape. 

 

The macula is at the centre of the retina and is responsible for detailed central vision. The changes to the macula caused by vitreomacular traction are not painful but can cause your central vision to become blurry and/or distorted, where straight lines appear wavy or bent. These symptoms are also experienced in other conditions affecting the macula, such as age-related macular degeneration. 

 

When we are born, the vitreous is firmly attached to the retina. As we age, the vitreous becomes more watery and may eventually separate from the retina in a process known as ‘posterior vitreous detachment’. If the vitreous doesn’t fully separate from the retina, the remaining partially attached vitreous can ‘pull’ and distort the macula – this is vitreomacular traction. In some cases, vitreomacular traction can progress and form a macular hole.

 

Vitreomacular traction syndrome is diagnosed and monitored with Optical Coherence Tomography (OCT), a non-invasive scan of the tissue layers of the retina. Retinal photographs may also be taken to confirm and document the extent of your condition. 

 

There are currently three main options for managing vitreomacular traction syndrome:

 

Observation –  If symptoms do not impact on your daily life, your ophthalmologist may decide just to monitor your condition. Some cases of vitreomacular traction syndrome resolve spontaneously.  You should also use an Amsler grid regularly, to test for any changes in vision symptoms. 

 

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 under local anesthesia. In most cases, patients experience a significant improvement in vision. After the surgery, you will be given eye drops to use for several weeks. Your ophthalmologist will discuss the benefits and risks of surgery and provide instructions regarding postoperative care.

 

Ocriplasmin – marketed as Jetrea® – is a drug treatment, suitable in select cases, which is administered as a single injection into the eye. It works by dissolving the adhesion between the vitreous and the macula, thereby relieving the traction. 

 

 

Macular Disease Foundation Australia exists to provide information and support for people with macular disease, their families and carers. Our Helpline can provide you with a free Amsler grid and further information about your condition, and can advise you on the various supports and services available: 1800 111 709.