A study coordinated by Vall d'Hebron determines the prevalence of vitreoretinal interface abnormalities in participants over 45 years of age

A cross-sectional multicenter study by 17 Spanish hospitals and coordinated by the Department of Ophthalmology of the Barcelona's Vall d'Hebron Hospital, has revealed that the prevalence of abnormal vitreoretinal interface reaches 2.7% in a healthy population over 45 years of age. Therefore, and because they are pathologies without associated symptoms in the early stages, it is advisable to perform the detection by Optical Coherence Tomography (OCT) on any routine or preoperative evaluation, particularly in elderly patients.

The objective was to determine the prevalence of vitreoretinal interface abnormalities: vitreomacular traction, epiretinal membrane and lamellar hole.
The subjects in this study were adults of both sexes and older than 45 years old (45 to 90) who attended the Ophthalmology consultation as companions of a patient. Ophthalmology Services from 17 Spanish hospitals participated, including Vall d'Hebron University Hospital, a reference centre for the study. The study monitoring and management tasks were carried out by the Academic Research Organization (ARO) of the Vall d’Hebron Hospital Research Institute in Barcelona, Spain.

Exclusion criteria were: retinal disease, uveitis, history of ocular trauma or previous intraocular surgery (including cataract surgery and intravitreal), severe myopia (> 6 diopters) and poor ocular media transparency.

2,257 participants (a sample of 4490 eyes) were included in the study with an average age of 59.5 years. 32.8% were male (740) and 67.2% women (1,517). They were subjected to an ocular study with Optical Coherence Tomography (OCT) or swept-source OCT.

Conclusions

The prevalence of abnormal vitreoretinal interface significantly increased with age, from 0.1% in the eyes of the participants of 45 and 55 to 7.2% in the eyes of the participants over 75 years of age. Instead, vitreomacular adhesion (VMA) was more frequent in younger participants.

Vitreoretinal interface abnormalities in 61 participants were diagnosed, representing a prevalence of 2.7% in the group of subjects studied. The prevalence was higher in men (3.6%) than in women (2.2%) but the differences were not significant, says Dr. Miguel A. Zapata, a specialist ophthalmologist in Crystalline/Vitreous-Retina, researcher at the Research Group of Ophthalmology at Vall d'Hebron Research Institute (VHIR) and first author of the study.

The vitreomacular traction (VMT) was observed in 14 participants (0.6%), the epiretinal membrane (ERM) in 44 (1.9%), and the macular lamellar hole in 3 patients (0,1%). None of the patients presented full-thickness macular hole (FTMH).

Patients that suffered from a vitreoretinal interface abnormality in one eye were more likely than other patients to have VMA, EMR or VMT in el other eye.

The vitreoretinal interface anomalies were not related with the presence of diabetes or hypertension.

Vitreoretinal interface abnormalities

Abnormalities of the vitreoretinal interface including vitreomacular traction, epiretinal membrane, full thickness macular hole and lamellar macular hole.

Patients with these conditions may be asymptomatic or have decreased visual acuity or metamorphopsia. According to the 2013 classification of the International Study Group of Vitreomacular Traction, vitreomacular adhesion is not considered a disease but a aging process itself of the vitreous body.