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Shelley Day, Jose A Martinez, Peter A Nixon, Mark Levitan, Clio Armitage Harper; Intravitreal gas injection for the treatment of vitreomacular traction syndrome. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):1234.
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© ARVO (1962-2015); The Authors (2016-present)
Vitreomacular traction syndrome can cause symptomatic metamorphopsia and decrease in visual acuity. While it is typically treated with vitrectomy surgery or intravitreal ocriplasmin injection, these procedures can be invasive and costly. The purpose of this retrospective, consecutive case series is to evaluate the efficacy of intravitreal gas injection for treatment of symptomatic vitreomacular traction syndrome.
Ten eyes of 10 patients with symptomatic vitreomacular traction on spectral-domain optical coherence tomography (sdOCT) received an intravitreal injection of 0.3 mL of 100% sulfur hexafluoride (SF6) or perfluoropropane (C3F8). The primary outcome was the number of eyes with release of vitreomacular traction on sdOCT at one month after treatment. Secondary outcomes included change in visual acuity and central subfield thickness 1 month after treatment.
Six patients (60%) had resolution of vitreomacular traction on sdOCT by one month after injection. Of these, 2 (20%) developed full thickness macular holes. Mean visual acuity at one month improved slightly after injection by 0.09 logMAR units, although this change was not statistically significant (p = 0.20). Central subfield thickness on sdOCT decreased by an average of 46.5 microns after injection (p = 0.002). All eyes with release of vitreomacular traction had pre-treatment vitreomacular adhesion of less than 521 microns. No post-injection complications were noted.
Intravitreal injection of expansile SF6 or C3F8 gas is a low-cost and minimally invasive alternative for the treatment of symptomatic vitreomacular traction syndrome. Further study is warranted.
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