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Yue Zhao, Yuji Itoh, Justis P Ehlers, Sunil K Srivastava, Rishi P Singh, Peter K Kaiser; 1 year outcomes of intravitreal octriplasmin for symptomatic vitreomacular traction. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):1230.
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Intravitreal ocriplasmin for symptomatic vitreomacular adhesion (sVMA) permits early intervention and avoids surgical risk. Initial reports describe visual and anatomic changes in the first month after injection. We aim to follow these changes for at least one year after treatment.
We assessed effect of ocriplasmin 0.125ug in a retrospective case series of Cole Eye Institute patients with sVMA. Eyes were categorized into two groups: eyes treated with ocriplasmin alone, and eyes requiring further vitrectomy (V). Ocriplasmin alone eyes were further subdivided into responders (R), defined by sVMA resolution, and non-responders (NR), defined by lack of resolution. Primary outcome was incidence of sVMA resolution. Secondary outcomes included changes in visual acuity (VA), changes in optical coherence tomography (OCT) measurements, and incidence of vitrectomy in eyes followed for at least one year. Comparisons were analyzed using Wilcoxan tests and presented as count/percentage or median/interquartile range.
Of 19 ocriplasmin treated eyes, 9 (47%) demonstrated OCT confirmed sVMA release. Median time to resolution was 7 days. sVMA did not resolve in 10 eyes, of which 6 (32%) eyes required further vitrectomy. 14/19 (74%) eyes were followed for a minimum of one year: 8 ocriplasmin alone (5 R, 3 NR) and 6 vitrectomy (V) eyes. Baseline VA was significantly lower in eyes treated with ocriplasmin alone (logmar 0.29, 0.18-0.42) compared to vitrectomy eyes (0.40, 0.32-0.54, p=0.03). Final VA was 0.20 in ocriplasmin alone and 0.24 in vitrectomy eyes (p=0.84). In ocriplasmin alone eyes, VA improved by -0.14 in both responder and non-responder eyes. Time to best VA was 142 days in responders and 129 days in non-responders (p = 0.55). OCT central subfield thickness was thinner in the ocriplasmin-alone eyes than in the vitrectomy eyes at baseline (267um vs. 390um, p=0.05) and follow-up (227um vs. 309.5um, p=0.03). Transient subretinal fluid was noted in 7/14 (50%) eyes. 6 eyes (43%) had macular holes at baseline, 3 resolved with ocriplasmin and 3 required vitrectomy.
This study ocriplasmin outcomes after one year follow up. Visual acuity improved over several months in both ocriplasmin responders and non-responders, and final visual acuity was similar across groups. OCT measurements differed at baseline and at final follow-up in ocriplasmin eyes when compared to those requiring vitrectomy.
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