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Anuj Chawla, Jorge Fortun, Bascom Palmer Eye Institute; Clinical Results of Ocriplasmin For Symptomatic Vitreomacular Traction Syndrome. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):1224.
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To evaluate the clinical response of ocriplasmin for treatment of vitreomacular traction syndrome and determine anatomic and patient characteristics to stratify potential response to treatment. The MIVI-TRUST trials trials were two, parallel, phase III randomized control trials comparing the effectiveness of an ocriplasmin injection to a placebo saline injection in the treatment of symptomatic vitreomacular adhesion. The trials also determined certain positive predictive factors. These include age less than 65 years of age, absence of epiretinal membrane (ERM), phakic lens status, and adhesion <1500 um. The purpose of this study was to evaluate the effectiveness of ocriplasmin in the clinical setting, and evaluate anatomic changes that occur post injection using spectral domain OCT.
This is a retrospective case series of 35 consecutive patients who received ocriplasmin for symptomatic vitreomacular traction syndrome. OCT was used to determine if the vitreomacular traction was released within 30 days of injection. Pre and post injection best corrected Snellen visual acuity was measured and converted to logmar values. The age of the patient, presence of ERM, lens status, and size of the adhesion were documented. Anatomic changes seen on OCT were also recorded.
35 patients received ocriplasmin for symptomatic vitreomacular traction. 15 of these patients had release of the vitreomacular traction by day 28. Of the 15 patients that demonstrated release of the vitreomacular traction, 12 had 3 or more positive predictive factors (age <65, absence of ERM, phakia, and adhesion less than 1500 um). The average change in visual acuity when converted to logmar is 0.0367.
Patient treated with ocriplasmin for symptomatic vitreomacular traction experienced release in 15 out of 35 injections (42.8%). Of the 15 patients that had a postive response 12 (80%) had 3 or more positive predictive factors. Overall there was an improvement in visual acuity, with a logmar value of 0.0367. Anatomic changes seen after injection include cystoid macular edema, persistent sub-retinal fluid, and inner segment - outer segment junction changes. These results support the use of ocriplasmin for sVMA and show an improved response rate compared to the MIVI-TRUST trials.
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