June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Safety and Efficacy of Intravitreal Ocriplasmin in Diabetic Macular Edema with Vitreomacular Adhesion – results of a guided intravitreal injection method
Author Affiliations & Notes
  • João Coelho
    Ophthalmology, Centro Hospitalar Universitário do Porto, Santo Tirso, Porto, Portugal
    Physiology and Cardiothoracic Surgery, Faculdade Medicina Universidade do Porto, Porto, Portugal
  • Bernardete Pessoa
    Ophthalmology, Centro Hospitalar Universitário do Porto, Santo Tirso, Porto, Portugal
  • Nuno Alves Correia
    Ophthalmology, Centro Hospitalar Universitário do Porto, Santo Tirso, Porto, Portugal
  • João Melo Beirão
    Ophthalmology, Centro Hospitalar Universitário do Porto, Santo Tirso, Porto, Portugal
    Ophthalmology, Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
  • Angelina Meireles
    Ophthalmology, Centro Hospitalar Universitário do Porto, Santo Tirso, Porto, Portugal
    Ophthalmology, Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
  • Footnotes
    Commercial Relationships   João Coelho, None; Bernardete Pessoa, None; Nuno Correia, None; João Melo Beirão, None; Angelina Meireles, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 3700. doi:
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      João Coelho, Bernardete Pessoa, Nuno Alves Correia, João Melo Beirão, Angelina Meireles; Safety and Efficacy of Intravitreal Ocriplasmin in Diabetic Macular Edema with Vitreomacular Adhesion – results of a guided intravitreal injection method. Invest. Ophthalmol. Vis. Sci. 2017;58(8):3700.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To evaluate the safety and efficacy of a single intravitreal injection of ocriplasmin (125μg), or up to two injections, in patients with diabetic macular edema (DME) and focal or loose broad vitreomacular adhesion/traction (VMA) with the purpose of VMA release without the need of vitrectomy. We also analysed the results of a guided intravitreal injection method of ocriplasmin (125μg) proximal to VMA.

Methods : Single centre observational case series of 24 consecutive eyes of 18 patients who received intravitreal ocriplasmin for DME with VMA. Adjunct treatment, when required, with laser and intravitreal injections of corticosteroids and/or antiangiogenic were performed. Minimum follow-up of one month after ocriplasmin injection was defined. The primary endpoint was the resolution of VMA during the follow-up. The secondary endpoints included the maximal central macular thickness (MCMT) and best corrected visual acuity (BCVA) changes from baseline and the effect on the number of intravitreal injections (corticosteroids or antiangiogenic).

Results : The mean follow-up was 294±157 days. Of the 18 patients, with an average age of 68 years, 55,5% are male and 58% of the eyes are phakic. The mean measure of the adhesion was 665μm (ranging from 128μm to 2115μm). The release of the VMA occurred in 66,7% of cases. VMA resolution of 100% (7 eyes) was achieved with the guided injection method and 52,9% with the unguided method, p<0,05. After ocriplasmin the mean BCVA improved from 69.0 (EDTRS, early diabetic treatment retinopathy study, letters) to a maximum BCVA during follow-up of 79.6 letters (p=0,001). Mean MCMT improved from 374.6μm at baseline to 342.1μm during the follow up (p<0,001). There was a significant reduction in the number of intravitreal injections after ocriplasmin in the eyes with VMA release (p=0,005) with no reduction in eyes without VMA release. The side effects with both techniques were mild and transitory.

Conclusions : This treatment approach in DME associated with VMA seems to be safe and effective with a significant improvement in visual acuity and macular edema being the patient’s selection and the timing of injection crucial for a successful treatment. The preliminary results of the guided injection method of ocriplasmin are favourable with resolution of the VMA being achieved in all cases.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

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