A Review of Current Management of Vitreomacular Traction and Macular Hole
Table 1
Gass classification
OTC findings
Classification IVTS
Stage 0
Minimal changes in the foveal contour with perifoveal detachment of the perifoveal vitreous cortex without traction
VMA
Stage 1A: imminent MH
Foveal cysts and sensory foveolar detachment associated with perifoveal detachment with traction of the posterior vitreous on the foveal internal limiting membrane
VMT
Stage IB
Cyst in the outer retina causing rupture of the cones layer. Perifoveal detachment of posterior vitreous
VMT
Stage 2: small MH
Full-thickness MH of small diameter, with partial rupture of the internal wall of the cyst. Partial detachment of the posterior vitreous, which still remains adhered to the operculum
FTMH small/medium with VMT
Stage 3: large MH
MH of a larger size. Total detachment of the posterior vitreous at the level of the macular area, which persists adhered to the papilla. Occasionally, a free operculum adhered to the posterior vitreous can be seen
FTMH medium/large with VMT
Stage 4: full-thickness MH with PVD
Total detachment of the posterior vitreous. In some cases, the vitreous is not observed on OCT scans. Larger diameter of the hole with halo of outer retinal detachment in many occasions