July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Predictive factors for successful treatment with intravitreal ocriplasmin
Author Affiliations & Notes
  • Michael Grinton
    Sunderland Eye Infirmary, National Health Service (NHS), United Kingdom
  • Jon Rees
    School of Psychology, University of Sunderland, United Kingdom
  • Maged S Habib
    Sunderland Eye Infirmary, National Health Service (NHS), United Kingdom
  • Roxane Hillier
    Royal Victoria Infirmary, National Health Service, Newcastle, United Kingdom
  • Daniela Vaideanu-Collins
    James Cook University Hospital, National Health Service, Middlesbrough, United Kingdom
  • Smith Jonathan
    Sunderland Eye Infirmary, National Health Service (NHS), United Kingdom
  • David Steel
    Sunderland Eye Infirmary, National Health Service (NHS), United Kingdom
  • Footnotes
    Commercial Relationships   Michael Grinton, None; Jon Rees, None; Maged Habib, None; Roxane Hillier, None; Daniela Vaideanu-Collins, None; Smith Jonathan, None; David Steel, Alcon (C), Alcon (F)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 2008. doi:
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      Michael Grinton, Jon Rees, Maged S Habib, Roxane Hillier, Daniela Vaideanu-Collins, Smith Jonathan, David Steel; Predictive factors for successful treatment with intravitreal ocriplasmin. Invest. Ophthalmol. Vis. Sci. 2019;60(9):2008.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Ocriplasmin (Jetrea) is a truncated form of human plasmin that is used as an option to treat vitreomacular traction (VMT). The clinical understanding of ocriplasmin continues to evolve over time and although there have been multiple factors associated with successful treatment, the success rate is variable and the outcome remains hard to predict. We designed a retrospective study to identify new predictive factors associated with successful treatment with ocriplasmin.

Methods : Eyes treated with intravitreal ocriplasmin between August 2013 and May 2016 at 3 centres in the north east of England were retrospectively reviewed. Age, sex, pre and 4-week post injection visual acuity were noted. Preoperative Heidelberg Optical Coherence Tomography (OCT) scans were reviewed and a variety of features classified including: width of VMT (μm), elevation of vitreous attachment (μm), and the angle between the internal limiting membrane (ILM) and posterior vitreous cortex at 500 microns nasal to the fovea (β nasal 500). The patients were reviewed 4 weeks post ocriplasmin injection and the presence or absence of VMT release (or hole closure in those with a macular hole) was noted.

Results : 81 eyes were treated with ocriplasmin. 31 (38%) had a full thickness macular hole (FTMH). 26 out of the 50 patients (52%) with VMT without FTMH had successful treatment with release of VMT. 7 out of the 31 patients (23%) with VMT and FTMH had release of VMT and closure of the hole.
Younger age (mean: 78.6 vs mean: 83.2, p=0.021, odds ratio 0.89 [95%CI 0.81-0.98]) was associated with an increased chance of a successful outcome in patients with VMT and no FTMH, while in a logistic regression lower VMT width approached significance as an additional significant predictor (mean 351μm vs mean 474μm, p=0.056 odds ratio 0.995 [95%CI 0.989-0.999]).
Better preoperative vision (mean 0.46 vs 0.83 LogMAR, p=0.035, d=1.16) and lower vitreous elevation (mean 311μm vs 419μm, p=0.003, d=1.64) was associated with an increased chance of a successful outcome (hole closure) in patients with FTMH.

Conclusions : The study identifies novel predictive factors for VMT resolution and allows clinicians to identify patients who are more likely to have a successful outcome with ocriplasmin treatment.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

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