Posterior Vitreomacular Adhesion and Risk of Exudative Age-related Macular Degeneration: Paired Eye Study

PURPOSE: To evaluate posterior vitreomacular adhesion as a risk factor for choroidal neovascularization (CNV) in age-related macular degeneration (AMD). DESIGN: Retrospective, observational case series. METHODS. We retrospectively reviewed optical coherence tomography (OCT) and fluorescein angiography (FA) of 251 consecutive patients with unilateral exudative AMD. Fellow eyes had no sign of exudative AMD. Vitreomacular adhesion was defined when posterior hyaloid line attached to inner retinal surface was seen in OCT. We compared the incidence of posterior vitreomacular adhesion between the 2 eyes and the association between CNV location and vitreomacular adhesion. RESULTS: We found posterior vitreomacular adhesion in 56 patients (22.3%), and 3 cases in which it was present in both eyes. CNV was mostly present in eyes with vitreomacular adhesion (44/53, 83%), and rarely found in eyes without vitreomacular adhesion (6/53, 11.3%; P = .0007). The location of vitreomacular adhesion was always observed over the area of the CNV in exudative eyes (50/50). CONCLUSIONS: Posterior vitreomacular adhesion is associated with CNV in AMD. Chronic vitreomacular traction may be a risk factor for the development of exudative AMD. (Am J Ophthalmol 2009;147:621-626. (C) 2009 by Elsevier Inc. All rights reserved.)