ABSTRACT
PURPOSE: To quantify the changes in vitreomacular interactions that occur with normal aging in normal eyes. METHODS: Spectral domain optical coherence tomography (SD-OCT, Spectralis; Heidelberg Engineering, Heidelberg, Germany) foveal scans of subjects with best corrected visual acuity better than 20/40 and no ocular pathology were included in the study. Each scan was analyzed to determine the status of vitreoretinal interface: complete vitreous adhesion, partial posterior vitreous detachment (PVD) with persistent vitreomacular adhesion (VMA), or complete PVD. Area of VMA was delineated using the Spectralis drawing tool and calculated in mm for each scan. Subjects, aged 10 years to 97 years, were divided into 9 age groups according to decade of life. RESULTS: Five hundred and sixty-six SD-OCT scans were analyzed. Area of VMA (mm) decreased sigmoidally (R = 0.99) with each decade of life. With aging, percentage of PVD increased while percentage of complete adhesion decreased. Males were found to have significantly larger area of VMA (mm) compared with females in the fifth through eighth decades of life, P < 0.05. CONCLUSION: Vitreomacular interface interactions throughout life are age and gender dependent. This adds to our current understanding of the normal aging process undergone by the vitreous, thereby providing assistance in the clinical differentiation between normal and pathologic vitreomacular interactions.
Subject(s)
Aging , Macula Lutea/pathology , Tissue Adhesions/physiopathology , Vitreous Body/pathology , Vitreous Detachment/physiopathology , Adolescent , Adult , Aged , Aged, 80 and over , Aging/pathology , Aging/physiology , Analysis of Variance , Female , Humans , Male , Middle Aged , Tomography, Optical Coherence , Young AdultABSTRACT
PURPOSE: To quantify the changes in vitreomacular interactions that occur with aging in diabetic eyes in comparison with age-matched control eyes. METHODS: Spectral-domain optical coherence tomography (Spectralis; Heidelberg Engineering) foveal scans of diabetic patients, without evidence of cystoid macular edema, were included. Twenty-five raster foveal scans were performed on every subject. Area of vitreomacular adhesion was delineated using the Spectralis drawing tool and calculated in square millimeter. Data collected included gender, race, best-corrected visual acuity, and posterior vitreous detachment status. Subjects were divided into age groups according to decade of life. RESULTS: Spectral-domain optical coherence tomography scans from 141 diabetic patients were analyzed. Area of vitreomacular adhesion (mm) showed a hyperbolic decline in diabetic patients (35.5 ± 0, 35.0 ± 3, 34.0 ± 3, 33.9 ± 5, 33.7 ± 6, 29.0 ± 11, 23 ± 15, 13 ± 15). With aging, incidence of posterior vitreous detachment increased and incidence of complete attachment decreased. CONCLUSION: Diabetes affects the magnitude of attachment of the vitreous gel to the macula that results in stronger and longer lasting attachment of the gel throughout life. Gender differences were not noticed in diabetic patients, suggesting that vitreomacular adhesion remains robust in both genders in diabetes despite aging.
