Vitreomacular Traction Syndrome (VMTS)

Vitreomacular traction (VMT) syndrome is characterized by an abnormal vitreous adherence to the macula due to incomplete posterior vitreous detachment (PVD). The resulting traction produces morphological changes of the macula. Patients may complain of decreased visual acuity, photopsia, micropsia, or metamorphopsia. On examination, VMT may present as a faint, translucent membrane adherent to the macula, although it is difficult to identify. The gold standard for diagnosis is optical coherence tomography (OCT), which shows a hyperreflective and thickened posterior hyaloid membrane with an abnormal foveal contour. In patients with good visual acuity and mild symptoms, observation is appropriate. However, if vision or macular traction progressively worsen, surgical intervention via pars plana vitrectomy with or without epiretinal membrane peeling may be needed. Complications of VMT can include full thickness macular hole, tractional macular schisis, and tractional foveal/macular detachment.