Abstract
Purpose:
To compares the effects of pars plana vitrectomy and intravitreal injection of ocriplasmin with observation in symtpmatic VMT
Methods:
retrospective study of patients who had symtomatic VMT . VMT was diagnosed by spectral domain optical coherence tomography . Main outcome measures included best-corrected visual acuity and VMT status (released vs not released) at baseline and the last follow-up.
Results:
Total of 51 eyes of 50 patients. 11 eyes in surgical group , 8 eyes in ocriplasmin group and 32 eyes in observation group. The mean ± SD follow up in surgical, ocriplasmin and observation groups were 10.27 ± 4.63 months, 3.87 ± 2.66 months and 6.27 ± 2.29 months, respectively. Baseline visual acuity (logMAR) in surgical, ocriplasmin and observation groups was 0.81 ± 0.24 (Snellen equivalent 20/125), 0.53 ± 0.29 (20/70) and 0.58 ± 0.25 (20/70), respectively. Visual acuity (logMAR) at the last visit in surgical, ocriplasmin and observation groups was 0.64 ± 0.26 (20/80), 0.52 ± 0.29 (20/70) and 0.57 ± 0.28 (20/70), respectively. The change in visual acuity between baseline and the last visit was significant in the surgical group (p=0.041) and was non-significant in the ocriplasmin (p=0.40) and observation (p=0.62) groups. At the last visit, VMT was released in all eyes (100%) in the surgical group, in 5 of 8 eyes (62.5%) in the ocriplasmin group and in 10 of 32 eyes (31.2%) in the observation group and was statistically significant in VMT release between surgery vs observation (P=0.00008) and surgery vs ocriplasmin (p=0.027) however was not sginificant between ocriplasmin and observation (p=0.1031). one case had lamellar hole after surgery, worsening of BCVA in one case after ocriplasmin injection and two in the observation group.
Conclusions:
Surgical intervention results in complete release of VMT with improvement in visual acuity. Intravitreal pharmacotherapy and observation have similar rates of VMT release with little change in visual acuity