Abstract
Purpose:
To evaluate the resolution rate of vitreomacular traction (<1500 µm) and the closure rate of macular holes (≤400µm) after therapy with intravitreal Jetrea® (Ocriplasmin) compared to transconjunctival vitrectomy in patients with symptomatic vitreomacular traction with or without macular hole (≤400 µm) in a clinical setting.
Methods:
We prospectively examined 21 eyes of 21 patients with symptomatic vitreomacular traction (VMT) with or without full thickness macular hole (FTMH), who underwent intravitreal injection of 0,1ml Jetrea®. And we retrospectively reviewed 18 eyes of 18 patients with vitreomacular traction with or without FTMH who underwent 23-gauge vitrectomy. In both groups visual acuity and SD-OCT ultrastructural parameters were measured before injection/vitrectomy. Resolution of VMT, closure of macular holes, visual acuity and SD-OCT ultrastructural parameters were evaluated again in both groups 1, 3 and 6 months after treatment.<br /> <br />
Results:
VMT resolved in 17 of 21 eyes treated with Ocriplasmin after 6 month (80.95%) as compared to 100% of eyes who underwent vitrectomy. In the Ocriplasmin group 5 eyes initially presented FTMH with VMT (23.80%), 2 of them were closed 1 month after Ocriplasmin treatment. The remaining 3 had vitrectomy with ILM-peeling and gas tamponade and closed thereafter. All FTMH were closed after 6 month. Best corrected visual acuity was 0.38±0.23 Log MAR at baseline, improving to 0.34±0.24 Log MAR at 6 months after ocriplasmin treatment. Best corrected visual acuity in the vitrectomy group improved from 0.55±0.29 Log MAR before operation to 0.53±0.51 Log MAR at 6 months postoperative. Foveal thickness was 355.95±114.53 µm at baseline, reducing to 277.77±40.26 µm at 6 months after ocriplasmin treatment. Foveal thickness of eyes who underwent vitrectomy was 494.61±126.02 µm at baseline, reducing to 330.2±88.85 µm at 6 months postoperative.<br />
Conclusions:
In the ongoing study, a large percentage of resolution of vitreomacular traction after intravitreal injection of Ocriplasmin was observed, and 2 out of 5 macular holes closed. This was further associated by an improvement of visual acuity and reduction of foveal thickness.<br />