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Vitreomacular Traction (VMT):

What is VMT and VMA?
Vitreomacular Traction (VMT) is a condition caused when the vitreous jelly has an abnormal persistent adhesion to the central retina (the macula). This produces symptomatic Vitreomacular Adhesion (VMA).

VMT Pre and Post Op
OCT scan of severe VMT showing elevation of central macula by vitreous traction. OCT scan of same patient after vitrectomy surgery, showing traction removed.

What are symptoms of VMT and VMA?
Distortion and reduction in central vision. Straight lines will appear wrinkled or bent. In severe cases a defect in central vision may occur.

How can it be treated?
Severe VMT has traditionally been treated by vitrectomy, where the vitreous jelly is removed, together with the traction, and the macula settles to the normal position. However, in October 2013, NICE approved use of an intravitreal injection of JETREA in the UK, as a more straightforward treatment of early VMT, without the need for complicated intraocular surgery.

What is JETREA (Ocriplasmin)?
JETREA is an enzyme which is injected into the eye in a tiny volume, and works by dissolving the adhesion between the vitreous and the macula. It is used to treat patients with symptomatic VMA, and can also be used to treat patients with small macular holes. In the absence of macular hole or epiretinal membrane, relief of VMT is achieved in up to 30% of cases by day 28 following intravitreal JETREA injection.

What are the risks of treatment?
JETREA appears to be well tolerated in the majority of patients. 8% patients can experience a transient drop in vision, which generally recovers over a 2 week period without treatment. Symptoms of flashing lights and floaters in the early stages are common. There is a very small risk of infection, as with any intraocular procedure, and retinal detachment can occasionally occur, requiring further treatment. Mr Charles will discuss all risks and benefits of treatment with you at your initial consultation.


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