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Stefano Erba, Sara Bochicchio, Mariano Cozzi, carlo domenico bianchi, Matteo Giuseppe Cereda, Giovanni Staurenghi; Wild-field Spectral-Domain OCT findings of eyes with symptomatic vitreo-foveal traction treated with intravitreal Ocriplasmin: a look outside the macula.. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):1210.
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To evaluate the baseline features and the changes of vitreo-papillary adhesion(VPA) and vitreo-retinal adhesions(VRA) till the mid periphery of patients that underwent an intravitreal Ocriplasmin injection (Jetrea, Thrombogenics USA, Alcon/Novartis EU)
A retrospective case series of patients treated with Ocriplasmin for sVFT selected on the basis of the MIVI-TRUST trial results. Images of single SD-OCT B-scans (Heidelberg Spectralis, Heidelberg Engeneering, Germany) passing through the fovea were obtained till temporal and nasal mid periphery (horizontal scans), and till superior and inferior mid periphery (vertical scans). All patients underwent SD-OCT before intravitreal Ocriplasmin injection, after one week and one month. We also measured the variations of vitreous detachment from the traction to the mid periphery in all the quadrants
Seven patients ( 7 eyes), two male and five female, met the inclusion criteria. 5 eyes presented sVFT and 2 eyes had sVFT with a full thickness macular hole. At baseline all 7 eyes had VPA; all 7 eyes had visible VRA in the nasal side; 6 eyes had visible VRA in all the quadrants; in 1 patient VRA was visible only nasally. After Ocriplasmin injection sVFT resolved in 5 of the 7 patients. VPA resolved in two eyes where also a resolution of the mid periphery VRA was noted in all the quadrants. Nasal VRA persisted in the others 5 patients. Four patients had still a visible VRA in all the quadrants after the injection. Measures of vitreous detachment showed, in all the quadrants, only mild increase after injection
Ocriplasmin injection induced a total PVD with the complete resolution of the sVFT and the VPA in only two eyes of our series. While VFT resolved in 5 of 7 eyes, in the majority of our patients no significant changes were noted in the mid periphery VRA. Our results confirm that Ocriplasmin injection is surely an effective option for the treatment of the sVFT. On the other hand it is not clear if ocriplasmin could only resolve the sVFT or accelerate and even induce a total PVD from the back of the eye. Moreover we still don’t know if the evaluation of the relationship between the vitreous and the retina and the head of the optic nerve and the mid periphery could provide more informations for a careful selection of the patients eligible for the treatment with Ocriplasmin
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