Vitreomacular Traction Treatment

After a diagnosis of vitreomacular traction (VMT), there are usually three treatment options:

Observation or a “wait-and-see” approach. If your VMT is mild and not affecting your vision, treatment might not be needed. Because some cases of VMT will resolve on their own, you and your ophthalmologist may decide to observe (watch) the condition with follow-up visits. You also will be asked to monitor your vision at home each day with an Amsler grid. Your ophthalmologist will review proper use of the Amsler grid.

Amsler Grid

For someone with VMT, an Amsler grid may appear to have wavy lines or blank spots.

Surgery. Severe cases of VMT can lead to vision-threatening retinal conditions, such as:

• macular hole (when tugging of the vitreous creates a hole in the macula)
• macular pucker (when macular scar tissue builds up and distorts vision),
• or cystoid macular edema (swelling of the macula).

In these cases, a procedure called a vitrectomy may be recommended to restore the macula to its normal (lying flat) shape. The surgeon uses tiny instruments to remove the vitreous from the eye and replaces it with a saline fluid. Any scar tissue on the macula is also peeled with special instruments under a microscope. This relieves the traction that is damaging the macula.

Medication. Some people with serious cases of VMT might not be good candidates for vitrectomy surgery. A medication called ocriplasmin is a treatment option for these patients. The drug is given by intravitreal injections (injection into the center of the eye) and works by dissolving the tiny protein fibers that connect the vitreous with the macula.