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Chiara Preziosa, Isabella D'Agostino, Ugo Nava, Stefano Erba, Matteo Giuseppe Cereda, Ferdinando Bottoni, Giovanni Staurenghi; Ocriplasmin for vitreo-macular traction: a Wide-Field OCT Study. Invest. Ophthalmol. Vis. Sci. 2016;57(12):4047.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the baseline features and the changes of vitreo-retinal adesion (VRA) and retinal outer layers outside the macula in patients that underwent an intravitreal Ocriplasmin injection (Jetrea, Thrombogenics USA, Alcon/Novartis EU). To study the relation between vitreous detachment and the attenuation of retinal outer segment signal.
A retrospective case series of 13 patients treated with intravitreal Ocriplasmin injection, ten with vitreo-macular traction (VMT) and three with macular hole (MH). Each eye has been scanned in 5 different locations, 3 horizontal B-scan (central, temporal and nasal) and 2 vertical B-scan (superior and inferior) using the 55° Wide Field OCT lens (HRA Spectralis, Heidelberg Engineering, Heidelberg, Germany).
A complete protocol of 5 scans was available for all the patients at baseline and 1 week, 1 month, 3 and 6 months post injection. At baseline all patients presented a vitreous-papillary adhesion (VPA), one patient had vitreous adherence nasally only and one patient had vitreous detached temporally only. The signal of outer segment was normal in all patients. After Ocriplasmin injection VMT resolved in 10 patients (76%), 3 of them presented a complete posterior vitreous detachment (PVD). 7 patients showed an attenuation of photoreceptor outer segments (54%) that involved all quadrants: in particular 6 of them with VMT resolution and 1 with non PVD and no VMT resolution. In 3 patients with VMT resolution the attenuation involved also areas with no PVD. Shallow, peripheral sub-retinal detachment was visible in 3 patients: all these 3 patients had attenuation of photoreceptor outer segment, 2 patients had a complete PVD and 1 had no PVD and no VMT resolution. In all the patients attenuation of the outer segment as shallow sub-retinal detachment resolved during the follow-up.
VMT are characterized by shallow vitreous detachment around the fovea always associated to a VPA. Rarely an initial peripheral vitreous detachment is visible. Intravitreal Ocriplasmin injection induces resolution of VMT and rarely a release of a VPA and a complete PVD. It can also induce and acute panretinopathy not related to vitreous detachment, characterized by an attenuation of photoreceptor outer segments layers involving all the retina area and shallow peripheral sub-retinal detachment.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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