Vitreomacular interface diseases: pathophysiology, diagnosis and future treatment options

Over the past two decades, the role of vitreomacular adhesion in vitreomacular interface pathologies, such as vitreomacular traction syndrome, epiretinal membrane and macular hole, has been increasingly recognized. Abnormalities of the vitreoretinal interface may contribute to important retinal pathologies such as diabetic retinopathy, diabetic macular edema and age-related macular degeneration. The prevalence of many of these serious disorders is rising. Eyes with vitreomacular adhesion-related disorders can experience rapid deterioration of vision and function if not managed in a timely and effective manner. The only treatment option currently available is vitrectomy. Pharmacologic treatment options have advanced over the past decade, and the current strategy of ‘watchful waiting’ until symptoms worsen may not be acceptable in the future. This article reviews vitreomacular interface disorders, and explores the evidence of experimental agents that can potentially treat these conditions.