Vitreous & Retina

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Macular Diseases
Color photograph of the right fundus demonstrates a pseudohole. Intraretinal cystic changes caused by the vitreoretinal traction become apparent in the red-free image. OCT scan demonstrates the incomplete vitreous separation with vitreous attachment to the perifoveal retina.

  • Incomplete vitreous separation with persistent vitreous attachment to the macula
  • May also lead to the formation of epiretinal membrane, macular puckering, cystoid macular edema with or without fluorescein leakage, tractional macular detachment and frank macular hole
  • Spontaneous resolution has been reported
  • Clinical features:
    • Symptoms:
      • May be asymptomatic
      • Decreased vision
      • Metamorphopsia in the presence of macular pucker
    • Signs:
      • Dull foveal reflex
      • Wrinkling of the retina
      • Stretching or corrugating appearance of the retinal vessels
      • Pseudohole
  • Management:
    • Observation if symptoms have been stable
    • Vitrectomy with membrane peeling in patients with worsening vision of less than 20/50 and significant metamorphopsia

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