(VMTS is defined as a distinct clinical entity in which partial posterior vitreous detachment is present in combination with persistent macular adherence causing traction-induced visual deficit.1
Vitrectomy has been proposed as an option to relieve this anterior posterior traction on the macula, which generally causes macular oedema and may lead to macular detachment or macula hole.2
Retrospective reviews of vitrectomy for VMTS report improvement of vision varying from 75% with up to 40% attaining 20/50 vision or better following vitrectomy.1
However, vitrectomy is not without risks, including complications of cataract, epiretinal membrane formation and retinal breaks. Furthermore, a significant percentage of VMTS will resolve spontaneously, particularly after an intervention such as intravitreal injection.3
However, the natural history is only just beginning to be understood and it is still not known which cases will spontaneously resolve and which cases should be operated on. Yamada and Kishi reported that incomplete V-shaped posterior vitreous detachment leads to foveal retinal detachment and favourable surgical outcome.4
Our case suggests that V-shaped posterior vitreous detachment in VMTS in diabetic patients may herald spontaneous resolution.
- Spontaneous resolution of VMTS may occur in patients with diabetes who are candidates for vitrectomy surgery.
- A period of observation of 6 months following symptom onset in VMTS did not result in an adverse visual outcome following resolution of VMTS.
- V-shaped posterior vitreous detachment in VMTS in a patient with diabetes may indicate a favourable outcome following resolution.
- V-shaped vitreous detachment in VMTS may be observed for up to 6 months.
- This is a useful reminder that many conditions can be observed before operative intervention as they can resolve spontaneously.