This is a group of diseases of the retina caused by pathological changes at the anatomical boundary between the vitreous body and the retina in the eye.

Diseases of the vitreoretinal interface include tractional maculopathies, which affect the area of sharpest vision(macula) in the human eye. These diseases are referred to as "tractive" because the occurrence of tensile forces at the vitreomacular interface is characteristic of these diseases. These traction forces are caused by persistent connections between the vitreous body and the retina and/or by abnormal cell accumulations(epiretinal membranes) on the retinal surface. This can impair the normal function of the macula and lead to visual impairment.

Tractive maculopathies include, for example, epiretinal gliosis, vitreomacular traction syndrome, idiopathic macular hole, and incompletely penetrating macular defects such as macular layer hole, pseudo hole and epiretinal membrane foveoschisis.

The symptoms of tractive maculopathies vary depending on the type and severity of the tractive maculopathy. Some common symptoms are

1. Reduction in visual acuity. One of the most common symptoms is a deterioration of visual acuity in the central field of vision. It is difficult to read text or recognise details.
2. Distorted perception(metamorphopsia): Tractive maculopathies can lead to distorted vision. Straight lines are perceived as curved or wavy.
3. Changes in the perception of object sizes. This means that patients perceive their surroundings or certain objects as smaller or larger with the affected eye. In the case of micropsia, objects appear smaller than they actually are. Patients with macropsia perceive their surroundings or certain objects as enlarged with the affected eye. These micropsias or macropsias can be further symptoms of tractive maculopathies.
4. Central visual field defects. In advanced cases, tractive maculopathies can lead to losses in the central visual field. This can cause parts of the visual field to appear blurred or dark.

Tractive diseases in the macular region can be diagnosed by means of a comprehensive ophthalmological examination. In addition to the examination of thefundus (funduscopy), optical coherence tomography(OCT) is used as standard in clinical routine. This is an imaging procedure that produces high-resolution cross-sectional images of the retina. OCT enables the doctor to view the various layers of the retina in detail and recognise any structural changes. In the case of tractive maculopathies, OCT is the only way to reliably differentiate between various subtypes and categorise them into different stages. The procedure is non-invasive, painless and usually only takes a few minutes.

Early forms of the disease can initially be observed depending on the severity and level of suffering of the patient; therapy is not necessarily required here.

Advanced stages, on the other hand, can be treated with surgery to reduce the metamorphopsia and ideally to improve visual acuity(pars plana vitrectomy with membrane peeling). The main aim of this so-called "peeling" during macular surgery is to resolve the existing tractions (see "Retinal surgery").

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