Incomplete vitreous separation with persistent posterior vitreous attachment to the perifoveal retina is the hallmark of Vitreomacular Adhesion (VMA), which can be symptomatic. Metamorphopsia (distorted vision), with or without loss of vision, is the symptom I most commonly encounter in clinic.  This entity can lead to vitreomacular traction, epiretinal membrane formation, cystoid macular edema and frank macular hole.

 

Fortunately there is a new drug in the market for this condition – Jetrea, whose safety and efficacy were established in 2 clinical trials and is now FDA approved. The drug is manufactured by ThromboGenics. Upon complete separation of the posterior vitreous, patients’ symptoms improve and macular edema usually resolves. Jetrea is administered in the office through an intravitreal injection. In cases in which the drug fails to relieve the vitreous traction, pars plana vitrectomy, which mechanically separates the tissues involved, can be offered to the patient.