Current treatment strategies for vitreomacular traction and macular holes: a survey of retinal specialists in Germany

Background: To evaluate the different treatment strategies for eyes with vitreomacular traction (VMT) and macular holes (MF) regarding the indications and initiation of treatment. ObjectiveThe aim of this study is to facilitate clinical decision making by presenting the opinions of experienced retinal specialists in the context of the current literature and the changed approval situation for ocriplasmin. Material and methods: Members of the German Retina Society (RG) were questioned in an online survey. Based on a literature review a 100-question questionnaire was created and sent to all members of the RG via an electronic link to the online platform "LimeSurvey". Voluntary participation was possible from 15 October 2021 to 15 November 2021. Data collection and statistical analysis were anonymized. Results: The responses of the 115 participants were congruent with the presentation of the new S1 guidelines on this topic. The indications for active treatment of focal VMT without MF were postponed in favor of watchful waiting, with the individual symptoms of the patient playing a major role in the proposed temporal management. The results on the indications for vitrectomy are consistent and convincingly confirm the opinions on the efficacy and risk assessment of this therapeutic procedure. Conclusion: The results presented provide an overview of the consensus and controversies in the current treatment options for VMT and MF. With the help of a homogeneous and experienced group of retinal experts, it was possible to develop individual treatment strategies.