Vitreomacular Traction Syndrome

Vitreomacular traction syndrome (VMT) is a vitreoretinal interface disorder characterized by anomalous posterior vitreous detachment (PVD) with persistent vitreous attachment to the macula, resulting in anatomical distortions and functional visual impairment. VMT is associated with a spectrum of macular pathologies, including epiretinal membrane and macular holes. High-resolution optical coherence tomography (OCT) has revolutionized the understanding, classification, and diagnosis of VMT, enabling the precise visualization of tractional forces and their effects on the retina. The condition may resolve spontaneously or progress, requiring management strategies such as pneumatic vitreolysis or surgical intervention via pars plana vitrectomy (PPV). Epidemiological studies highlight a prevalence of VMT in aging populations, with risk factors linked to vitreous biochemistry and adhesion mechanisms. This chapter comprehensively explores the pathophysiology, classification, clinical features, diagnostic modalities, treatment options, and associated complications of VMT, emphasizing the role of OCT in diagnosis and monitoring. Advances in vitreoretinal surgery continue to improve visual and anatomical outcomes for affected patients. A thorough understanding of the vitreoretinal interface and its pathologic changes is essential for optimizing outcomes in patients with VMT.