Purchase this article with an account.
Dhruvesh Patel, Amar Shah, Andrew Melchioris, David G Miller; Evaluation of Visual Acuity and Acute Retinal Changes Following Intravitreal Injection of Ocriplasmin. Invest. Ophthalmol. Vis. Sci. 2017;58(8):1591.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To quantify the impact of ocriplasmin injection on visual acuity and evaluate its toxicity as manifested on optical coherence tomography (OCT).
A 1-year retrospective chart analysis was conducted on 66 eyes with symptomatic vitreomacular traction (VMT) that received 125μg intravitreal injection of ocriplasmin. Each patient underwent complete ocular assessment, including baseline OCT, prior to treatment. Follow-up data were assessed at approximately 1-week, 1-month, 3-month, 6-month and 1 year intervals post-injection. Primary outcome was development of ellipsoid zone degradation at any interval. Secondary outcomes included changes in visual acuity (VA), resolution of VMT at 1 month, closure of macular hole, and development of subretinal fluid. Snellen VAs were converted to ETDRS letters scores to stratify patients into groups ranging from greatly improved (≥ +15) to severely worse (≤-15) from baseline VA.
Fifteen of 66 eyes (22.7%) were noted to have ellipsoid zone degradation. Of these, 13 had resolution of degradation over a period of 3-9 weeks, with 2 eyes having persistent degradation. Visual acuity was documented for 62 patients 1 month post-injection. Twenty-one (33.9%) eyes were classified as worse or severely worse, whereas 24 (38.7%) were improved or greatly improved. At 6 months, 7/51 remained severely worse. Thirty-six of 66 eyes (54.5%) had complete resolution of VMT within 1 month of injection. Fifteen patients underwent PPV for persistent or worsening VMT. Nine of the 19 eyes with macular holes had resolution. Five of the 19 eyes had surgical closure of the macular hole. Subretinal fluid developed in 8 eyes post-injection, with complete resolution noted in 6 eyes over a period of 3-6 weeks.
Greater than 1 in 5 patients experienced ellipsoid zone degradation, suggesting a potential unintended toxicity of ocriplasmin to retinal tissue. Other findings include diminished visual acuities in 33.9% and 28.8% of patients at 1 month and 3 months, respectively. Despite resolution of VMT in over half our patients, this benefit must be weighed heavily against the significant presence of clinical risks.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
This PDF is available to Subscribers Only