24.
Posterior Vitreous Adhesion: a Potential Risk Factor
for Exudative AMD
Susanne Binder1, W. Brannath2, C. Glittenberg1, F. Zeiler1, J. Sebag3, I. Krebs1
(1Department of Ophthalmology, Rudolf Foundation Clinic, The Ludwig Boltzmann
Institute for Retinology and Biomicroscopic Lasersurgery, Vienna,
2Core Unit, Medical
Statistics and Informatics, Medical University Vienna,
3VMR Institute Huntington
Beach, USA / Department of Ophthalmology , University of Southern California, USA)
Background: To evaluate posterior hyaloid behaviour in eyes with exudative, non exudative
AMD and age-matched controls in a prospective observational case series.
Methods: B-scan ultrasonography and OCT were performed in 163 eyes from 82 subjects over
55 years of age. 50 eyes with exudative AMD, 57 with non-exudative AMD and 56 control eyes.
Main outcome measures: The number of eyes with complete posterior vitreous detachment
(PVD) by ultrasound and the number of eyes with central vitreo-macular adhesion by OCT.
Results: By ultrasonography, 17/50 (34 %) of eyes with exudative AMD had PVD as compared to 41(71.9 %) eyes with nonexudative
AMD (p = 0.00002) and 34/56(60.7 %) of controls (p = 0.017). OCT demonstrated persistent central vitreo-retinal
adhesion surrounded by a detached posterior vitreous cortex in 19/50(38 %) eyes with exudative AMD, significantely higher
than in non-exudative AMD (4/57 = 7% p < 0.0001) and controls(6/56;p = 0.002). High risk eyes with dry AMD showed a
trend toward higher vitreous adhesions as well.
Conclusion: Persistent attachment of the posterior vitreous cortex to the macula might be an additional risk factor inducing
exudative AMD.