What is the prevalence of vitreomacular traction (VMT) in the population over 50?

Prevalence of Vitreomacular Traction

Vitreomacular traction affects approximately 0.4% to 2.0% of U.S. adults over the age of 63, making it substantially less common than epiretinal membranes. 1

Population-Based Prevalence Data

The most robust prevalence data comes from the American Academy of Ophthalmology's Preferred Practice Pattern guidelines, which synthesize multiple population-based studies:

• In adults over age 63: VMT prevalence ranges from 0.4% to 2.0% 1
• In the Beaver Dam Eye Study (mean age 74.1 years) using spectral-domain OCT, VMT prevalence was documented at 1% to 2% 1
• In healthy participants ≥45 years: A 2017 Spanish cross-sectional study of 2,257 participants found VMT prevalence of 0.6% 2

Age-Related Patterns

VMT prevalence increases significantly with advancing age, similar to epiretinal membranes but at consistently lower rates. 1

• The condition is relatively uncommon before age 50 1
• Peak prevalence occurs in the 7th and 8th decades of life 1, 2
• VMT typically develops during posterior vitreous detachment (PVD), which most commonly occurs between ages 45-65 1

Comparison to Related Conditions

To contextualize VMT prevalence:

• Epiretinal membranes are substantially more common, affecting approximately 30 million U.S. adults aged 43-86 years, with prevalence ranging from 2.2% to 34.1% depending on detection methods 1
• VMT is 5-10 times less common than ERM in the same age groups 1
• Vitreomacular adhesion (a precursor state) is much more common at 29.3% in adults ≥45 years 2

Detection Method Impact on Prevalence

The imaging modality used significantly affects reported prevalence rates:

• Studies using spectral-domain OCT detect higher rates than those using fundus photography alone 1
• The Beaver Dam Eye Study showed that OCT-based detection yields more accurate prevalence estimates than clinical examination 1
• Routine OCT screening in preoperative cataract patients reveals previously undetected VMT in a small percentage of cases 1

Clinical Course Considerations

Approximately one-third (31.7%) of VMT cases undergo spontaneous release without intervention, typically occurring at a mean of 18 months (median 10.9 months) after initial diagnosis 3

• Only 4.1% of VMT patients require surgical intervention (pars plana vitrectomy) during follow-up 3
• Progression to full-thickness macular hole occurs in 12.5% of VMT cases, while 4.2% progress to lamellar macular holes 4

Important Clinical Caveats

VMT prevalence may be underestimated in routine clinical practice because:

• Many cases are asymptomatic or minimally symptomatic 1
• Detection requires OCT imaging, which may not be performed routinely in all patients over 50 2
• The condition can be confused with other optic nerve disorders when vitreopapillary traction is present 1