VITREOFOVEAL ATTACHMENT CAUSING METAMORPHOPSIA: AN ULTRAHIGH-RESOLUTION OPTICAL COHERENCE TOMOGRAPHY FINDING

Abstract

Optical coherence tomography (OCT) can be beneficial in visualization of the posterior hyaloid in both posterior vitreous detachment (PVD) and vitreomacular traction syndrome.1,2 PVD occurs as a normal phenomenon of aging, with 65% of healthy patients having PVD by their eighth decade of life.3 PVD is usually divided into partial and complete forms: complete detachment can often be detected with biomicroscopy and/or ultrasonography, while partial PVD is more difficult to detect. However, the use of OCT has allowed detection of partial PVD much more frequently; recently, OCT has been used to define several stages of partial PVD not seen biomicroscopically.1 Vitreomacular traction syndrome occurs when the posterior hyaloid remains attached at the macula while the more peripheral vitreous separates, causing anatomical distortion of the macula. This has been demonstrated clearly with OCT.2 However, to our knowledge, macular attachment of the posterior hyaloid without anatomical distortion of the retina has not been reported to cause visual symptoms. We describe four patients with visual distortion in whom the only abnormality at evaluation was a subtle OCT finding. Standard‐resolution OCT, capable of 10‐µm axial resolution,4 shows the posterior hyaloid inserting into apparently normal foveal contour. Ultrahigh‐resolution (UHR) OCT, capable of 3‐µm axial resolution,5 additionally demonstrates subtle distortion of the foveal contour not seen with standard OCT.