Non-diabetic diffuse macular edema associated with extrafoveal vitreous traction.

BACKGROUND The causative role of diffuse macular edema in various etiologies is often undetermined. OBJECTIVES To describe an association between extrafoveal vitreous traction and non-diabetic diffuse macular edema secondary to various ocular entities. METHODS In a retrospective study of eyes with non-diabetic diffuse macular edema, charts and optical coherence tomography scans demonstrating extrafoveal vitreous traction were analyzed. Excluded were diabetic patients and eyes that had vitreofoveal traction. A control group (n = 12) allowed for mapping of normal macular thickness. RESULTS Five eyes with macular edema were associated with extrafoveal traction, each secondary to and representing a different etiology. The causes were penetrating injury, cataract extraction, branch retinal vein occlusion, central retinal vein occlusion, and idiopathic. Vitreous traction was detected either at the papillomacular bundle (n = 3), superonasally to the fovea (n = 1), and at the optic nerve head (n = 1). The associated retinal edema (all eyes) and serous retinal detachment (four eyes) at the traction sites were in continuum with the foveal edema in each eye, manifesting as diffuse macular edema. Of the two modalities--the OCT-Line group program and the OCT-Automatic central program--only the former enabled detection of extrafoveal traction in each. CONCLUSIONS Diffuse macular edema secondary to various ocular diseases may be associated with extrafoveal vitreous traction. The OCT-Automatic central program may omit some of these extrafoveal traction sites. Further studies are required to validate these findings and to assess whether early vitrectomy may improve visual prognosis in these eyes.