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Priya Sharma, Ehsan Rahimy, Carl D Regillo; Pharmacologic Closure Rate of Full Thickness Macular Hole with Ocriplasmin—1 year follow-up data. Invest. Ophthalmol. Vis. Sci. 2016;57(12):4046.
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To analyze a single center’s experience with ocriplasmin for pharmacologic full-thickness macular hole (FTMH) closure associated with vitreomacular traction (VMT).
Single center retrospective study of 34 eyes that received intravitreal ocriplasmin for symptomatic FTMH with VMT. VMT release, FTMH closure, visual acuity changes, and anatomical characteristics on spectral domain optical coherence tomography (SD-OCT) were analyzed.
All eyes injected with ocriplasmin had focal VMT, and 32/34 (94%) had small (<250 microns) macular holes. Nonsurgical closure of FTMH was achieved in 12/34 (35%) eyes, and 21/34 (62%) eyes had VMT release. On average, eyes achieved pharmacologic FTMH closure within 20 days (range 4-32 days, with one occurring at 76 days) and pharmacologic VMT release within 16 days (range 3-76 days). Subsequent vitrectomy was performed in 21/22 (95%) eyes at an average of 50 days (range 12-182 days) after receiving ocriplasmin. Mean logMAR best-corrected visual acuity (BCVA) improved from 0.89 (20/155) at baseline to 0.40 (20/50) at final follow-up (p<0.001, mean 13.6 months follow-up). Overall average FTMH diameter in eyes that did not experience pharmacologic closure did not vary significantly from time of injection (293 um) to 1 month follow-up (318 um). Ellipsoid changes occurred in 16/34 eyes (47%), resolving in all eyes at an average of 35 days (range 3-76 days). One eye had pharmacologic closure of FTMH, but then reopened after 2 years. At final follow-up (mean 13.6 months), 30/34 (88%) of patients experienced an increase of two or more lines of vision, while 25/34 (74%) experienced an increase in three or more lines of vision. Out of 34 patients, none experienced a decline in two or more lines of vision at time of final follow-up.
In clinical practice, ocriplasmin achieved VMT release in 62% of treated eyes, with a 35% closure rate for FTMH. All 34 patients in this series experienced stability or improvement in vision at final follow-up, and ocriplasmin was not associated with widening of FTMH. There were no cases of permanent visual loss in this series.
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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