Abstract

    Vitreomacular Index as an Integral Indicator for Monitoring the Dynamics of Vitreomacular Traction Syndrome

    O.V. Kashtan, S.V. Gagarinov

    Ministry of Healthcare of the Russian Federation, Federal State Autonomous Institution “S.N. Fedorov National Medical Research Center ‘MNTK “Eye Microsurgery’” of the Ministry of Health of the Russian Federation (S.N. Fedorov NMRC “MNTK ‘Eye Microsurgery’)

    Background. Vitreomacular traction syndrome (VMT) is a potentially vision‑threatening disorder of the vitreoretinal interface with a prevalence of 22.5 per 100 000 population. Timely assessment of VMT progression is critical for preventing serious complications, including macular hole, tractional macular retinoschisis, and tractional macular detachment.

    Objective. To develop an integral indicator for quantitative assessment of vitreomacular traction syndrome dynamics and determination of indications for surgical treatment.

    Materials and Methods. A vitreomacular index (VTI) is proposed, calculated by the formula: VTI = (P × C) / 1000, where P is the area of posterior hyaloid membrane attachment (μm²), C is central retinal thickness (μm).

    Parameters are determined by optical coherence tomography (OCT).

    Results. Clinical testing of the method demonstrated the effectiveness of VTI in quantitative assessment of tractional changes dynamics at the vitreoretinal interface.

    A clear relationship was identified between index dynamics and clinical course of VMT:

    An increase in VTI indicates progression of traction and serves as an objective criterion for the need for surgical intervention (vitrectomy).

    A decrease in VTI indicates positive dynamics — weakening of tractional impact, stabilization, or regression of the pathological process.

    The use of VTI enables:

    • standardization of the assessment of vitreomacular tension degree;

    • monitoring of condition dynamics during conservative observation;

    • quantitative justification of timing and indications for surgical treatment;

    • comparison of treatment outcomes across different patients and clinical centers.

    Conclusion. The vitreomacular index is an objective tool for monitoring VMT, allowing timely determination of indications for vitrectomy and prevention of complications. The introduction of VTI into clinical practice enhances diagnostic accuracy and personalization of management strategies for patients with VMT.

    Keywords: vitreomacular traction syndrome, vitreomacular index, optical coherence tomography, vitreoretinal interface, posterior vitreous detachment, macular hole, vitrectomy.