Vitreomacular traction (VMT) is pathological persistent adherence of cortex vitreus in macula region due to incomplete posterior vitreous detachment. With tractional forces in fovea resulting in structural changes in neuroretina and eventually decreased visual acuity. VMT may sometimes resolve spontaneously. Untreated may lead to lamellar defects or even full thickness macular hole. Usually therapeutic intervention is required. Golden standard is pars plana vitrectomy. Other newer methods are intravitreal application of vitreolysis agents or pneumatic vitreolysis. Pneumatic vitreolysis is intravitreal application of gas. It is not entirely understood how pneumatic vitreolysis affect posterior vitreal detachment. It is suggested, that intravitreal application of gas increase liquefaction of vitreous, by creating a new or enlarging an existing vitreous pocket by stretching the vitreous fibers surrounding the pocket. Furthermore mechanical movement of the gas buble itself can help release vitreal adhesion. The purpose of this small study is to assess effectiveness and safety of pneumatic vitreolysis in patients with VMT. As of march 2018 there ase 12 patients enrolled. In this study we have used 0,2 ml of C3F8. Prior to intravitreal application of C3F8, Acetazolamide 250 mg tbl p.o. is administered and IOP was monitored before and 20 min. after application. Preliminary result indicate that pneumatic vitreolysis is safe procedure, so far we had complication in only one patient, who developed full thickness macular hole 3 weeks after intravitreal injection of C3F8. Which was successful repaired by PPV. After 3 months, most of the patients had increased visual acuity compared to pre application. All this data so far is comparable to other studies done on this topic. We were surprised by lower rate of complete posterior vitreal detachment, which occurred in less than half of the patients after 3 months. But even partial posterior vitreal detachment let to evident decrease of tractional force applied to macula and to structural improvement of foveal neuroretina. Complete result will be part of the presentation.



Daniel Krzyzanek
Oční odd. KNTB a.s.
Czech Republic
Email : daniel.krzyzanek@seznam.cz
Cell Phone: +420608461588
Work Phone: +420608461588