Vitreomacular Interface Diseases
Compared with other retinal conditions, limited epidemiological data exist for VMA. However, due to the advent of advanced imaging technology, most notably OCT, the recognition of this condition and its progressive sight-threatening complications such as macular hole has increased in recent years. In 209 healthy subjects of 31–74 years of age, no posterior vitreous detachment was observed in 29.2% of eyes, incomplete perifoveal posterior vitreous detachment in up to three quadrants (stage 1) was present in 47.8% of the eyes, incomplete perifoveal posterior vitreous detachment in all quadrants, with residual attachment to the fovea and optic disc (stage 2) in 12.4% of eyes and incomplete posterior vitreous detachment over the posterior pole, with residual attachment to the optic disc (stage 3), was present in 1.9% of eyes. Complete perifoveal posterior vitreous detachment was identified in 8.6% of eyes. With age, the number of subjects with no posterior vitreous detachment decreased, while the number with incomplete or complete posterior vitreous detachment increased with an age-related progression. Epiretinal traction is observed frequently in highly myoptic eyes; it was present in 58 out of 125 (46.4%) highly myoptic eyes.
The prevalence of macular hole has been reported as one in 3300 and is usually diagnosed in those 55 years and older. The overall prevalence in the USA is approximately 3.3 cases in 1000 persons older than 55 years with a peak incidence at the seventh decade of life, and women are more affected than men. In India, the prevalence is 0.17% with a mean age of 67 years, similar to the rate of 0.16% found in the Beijing Eye Study. The incidence of macular hole in Olmsted County (MN, USA) was 7.8 persons and 8.69 eyes per 100,000 persons per year. The female-to-male ratio was determined to be 3.3:1, and bilateral idiopathic macular holes occurred in 11.7% of patients and accounted for 20.9% of the affected eyes. VMA was identified in 30% (39/132 eyes) of eyes with macular diseases including the following diagnoses: idiopathic epiretinal membrane (13 eyes), diabetic retinopathy (seven eyes), idiopathic macular hole (seven eyes), cystoid macular edema (seven eyes), and VMT syndrome (five eyes). VMT was observed in 14.6% of eyes with full-thickness macular hole and 14.3% of eyes with lamellar macular hole. In age-related macular degeneration, rates of VMA are around 35%.
Epidemiology of Vitreomacular Interface Diseases
Compared with other retinal conditions, limited epidemiological data exist for VMA. However, due to the advent of advanced imaging technology, most notably OCT, the recognition of this condition and its progressive sight-threatening complications such as macular hole has increased in recent years. In 209 healthy subjects of 31–74 years of age, no posterior vitreous detachment was observed in 29.2% of eyes, incomplete perifoveal posterior vitreous detachment in up to three quadrants (stage 1) was present in 47.8% of the eyes, incomplete perifoveal posterior vitreous detachment in all quadrants, with residual attachment to the fovea and optic disc (stage 2) in 12.4% of eyes and incomplete posterior vitreous detachment over the posterior pole, with residual attachment to the optic disc (stage 3), was present in 1.9% of eyes. Complete perifoveal posterior vitreous detachment was identified in 8.6% of eyes. With age, the number of subjects with no posterior vitreous detachment decreased, while the number with incomplete or complete posterior vitreous detachment increased with an age-related progression. Epiretinal traction is observed frequently in highly myoptic eyes; it was present in 58 out of 125 (46.4%) highly myoptic eyes.
The prevalence of macular hole has been reported as one in 3300 and is usually diagnosed in those 55 years and older. The overall prevalence in the USA is approximately 3.3 cases in 1000 persons older than 55 years with a peak incidence at the seventh decade of life, and women are more affected than men. In India, the prevalence is 0.17% with a mean age of 67 years, similar to the rate of 0.16% found in the Beijing Eye Study. The incidence of macular hole in Olmsted County (MN, USA) was 7.8 persons and 8.69 eyes per 100,000 persons per year. The female-to-male ratio was determined to be 3.3:1, and bilateral idiopathic macular holes occurred in 11.7% of patients and accounted for 20.9% of the affected eyes. VMA was identified in 30% (39/132 eyes) of eyes with macular diseases including the following diagnoses: idiopathic epiretinal membrane (13 eyes), diabetic retinopathy (seven eyes), idiopathic macular hole (seven eyes), cystoid macular edema (seven eyes), and VMT syndrome (five eyes). VMT was observed in 14.6% of eyes with full-thickness macular hole and 14.3% of eyes with lamellar macular hole. In age-related macular degeneration, rates of VMA are around 35%.
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