Vitreous body in the treatment of exudative age-related macular degeneration. Themedium is the message

Background: Intravitreal anti-vascular endothelial growth factor (VEGF) is the standard treatment for exudative age-related macular degeneration (AMD). The constitution of the vitreomacular interface varies greatly in cases of attached (with or without traction) or detached vitreous body, which can impact the effectiveness of the anti-VEGF treatment. Objective: Based on the current literature this article displays the current state of the science on whether the constitution of the vitreous body has an effect on the anti-VEGF treatment. Material and methods: The published data extracted from current trials and post hoc analyses concerning this topic are presented and put into the clinical context. Results: The presence of a vitreomacular adhesion reduces the efficacy of anti-VEGF treatment of exudative AMD. Posterior vitreous body detachment represents a positive prognostic factor concerning the efficacy of anti-VEGF treatment but not necessarily the prognosis for visual acuity. Conclusion: Patients with attached vitreous body need a more intensive treatment monitoring compared to patients with detached vitreous body. Therefore, in eyes with initial posterior vitreous body detachment receiving a treat and extend regimen, the interval between anti-VEGF injections can be extended to 4 instead of 2 weeks without endangering the success of treatment.