Vitreomacular Adhesion and Its Association With Age-Related Macular Degeneration in a Population-Based Setting: The Alienor Study

PURPOSE. The purpose of this study was to describe vitreomacular adhesion (VMA), diagnosed with spectral-domain optical coherence tomography (SD-OCT), its risk factors, and its association with AMD in a population-based study of French elderly subjects. METHODS. Six hundred twenty-two of 624 (99.7%) participants of the Alienor study (Bordeaux, France), >= 75 years of age, had gradable SD-OCT scans of the macula in at least one eye. VMA was defined as visible perifoveal vitreous separation with remaining vitreomacular attachment and unperturbed foveal morphologic features. Late AMD was classified from retinal color photographs, SD-OCT, and ophthalmologic history. Early AMD was classified from retinal photographs and defined by the presence of large drusen and/or reticular drusen and/or pigmentary abnormalities. RESULTS. The prevalence of VMA was 15.8%, decreased with age (18.1% in subjects 75 to 84 years of age versus 8.9% after 85 years of age), and was higher in men than women (20.6% vs. 12.8%). VMA also tended to be less frequent in eyes with a history of cataract surgery (odds ratio [OR] = 0.66, P = 0.05), after adjustment for age and sex. No associations of VMA with other risk factors (cardiovascular risk factors, dietary intake of omega-3 fatty acids, lifetime ultraviolet radiation exposure, major AMD genetic polymorphisms) were found. After multivariate adjustment, VMA was not significantly associated with early or late AMD (OR = 1.14, P = 0.70 and OR = 0.78, P = 0.51 for early and late AMD, respectively). CONCLUSIONS. VMA was visible on SD-OCT in 16% in this sample of elderly French subjects but was not associated with AMD. Prospective studies of the associations of VMA with AMD are needed.