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Macular Hole Progression following Ocriplasmin Intravitreal Injection.

Casswell E, Fernandez-Sanz G, Mitry D, Luk S, Zakir R - Case Rep Ophthalmol Med (2014)

Bottom Line: Ocriplasmin is a protease which has been approved for the treatment of symptomatic vitreomacular adhesion (VMA).A 63-year-old presented with blurred vision in the left eye and a best corrected visual acuity of 6/18.This persisted at 1 month after the injection.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Western Eye Hospital, London NW1 5QH, UK ; Moorfields Eye Hospital, London EC1V 2PD, UK.

ABSTRACT
Ocriplasmin is a protease which has been approved for the treatment of symptomatic vitreomacular adhesion (VMA). A 63-year-old presented with blurred vision in the left eye and a best corrected visual acuity of 6/18. Optical coherence tomography revealed VMA with an underlying macular hole and she subsequently underwent a left intravitreal ocriplasmin injection. One week after the injection, VMA had been released but with enlargement of the macular hole and a drop in her BCVA to 6/60. This persisted at 1 month after the injection. It is important to warn patients that ocriplasmin may lead to an enlargement of their macular hole with resultant loss in visual acuity.

No MeSH data available.


Related in: MedlinePlus

Spectral-domain optical coherence tomography (SD-OCT) 1 day prior (a), 14 days after (b), and 35 days after (c) intravitreal ocriplasmin injection. (a) Prior to ocriplasmin injection, there is vitreomacular adhesion (VMA), with an underlying macular hole (240 µm diameter) involving the outer retinal layers. (b) 14 days after ocriplasmin injection, there is a resolution of VMA with enlargement of macular hole (540 µm diameter), which is now at full thickness. (c) 35 days after ocriplasmin injections, the full thickness hole persists (556 µm diameter).
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fig1: Spectral-domain optical coherence tomography (SD-OCT) 1 day prior (a), 14 days after (b), and 35 days after (c) intravitreal ocriplasmin injection. (a) Prior to ocriplasmin injection, there is vitreomacular adhesion (VMA), with an underlying macular hole (240 µm diameter) involving the outer retinal layers. (b) 14 days after ocriplasmin injection, there is a resolution of VMA with enlargement of macular hole (540 µm diameter), which is now at full thickness. (c) 35 days after ocriplasmin injections, the full thickness hole persists (556 µm diameter).

Mentions: A 63-year-old woman reported blurred vision in her left eye, with best corrected visual acuity (BCVA) dropping from 6/6 (0.0 logMAR) to 6/18 (0.48 logMAR). She had no past ophthalmic history and was phakic. Spectral-domain optical coherence tomography (SD-OCT) revealed VMA with an underlying macular hole with no associated epiretinal membrane (Figure 1(a)). One week following an uncomplicated intravitreal ocriplasmin injection (125 µg in 0.10 mL), her BCVA was 6/60 (1.0 logMAR). Repeat SD-OCT revealed an enlarged full thickness macular hole (FTMH) with VMA release (Figure 1(b)). 35 days after injection, BCVA was 6/60 (0.92 logMAR) with a persistent enlarged FTMH (Figure 1(c)).


Macular Hole Progression following Ocriplasmin Intravitreal Injection.

Casswell E, Fernandez-Sanz G, Mitry D, Luk S, Zakir R - Case Rep Ophthalmol Med (2014)

Spectral-domain optical coherence tomography (SD-OCT) 1 day prior (a), 14 days after (b), and 35 days after (c) intravitreal ocriplasmin injection. (a) Prior to ocriplasmin injection, there is vitreomacular adhesion (VMA), with an underlying macular hole (240 µm diameter) involving the outer retinal layers. (b) 14 days after ocriplasmin injection, there is a resolution of VMA with enlargement of macular hole (540 µm diameter), which is now at full thickness. (c) 35 days after ocriplasmin injections, the full thickness hole persists (556 µm diameter).
© Copyright Policy
Related In: Results  -  Collection

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Show All Figures
getmorefigures.php?uid=PMC4279821&req=5

fig1: Spectral-domain optical coherence tomography (SD-OCT) 1 day prior (a), 14 days after (b), and 35 days after (c) intravitreal ocriplasmin injection. (a) Prior to ocriplasmin injection, there is vitreomacular adhesion (VMA), with an underlying macular hole (240 µm diameter) involving the outer retinal layers. (b) 14 days after ocriplasmin injection, there is a resolution of VMA with enlargement of macular hole (540 µm diameter), which is now at full thickness. (c) 35 days after ocriplasmin injections, the full thickness hole persists (556 µm diameter).
Mentions: A 63-year-old woman reported blurred vision in her left eye, with best corrected visual acuity (BCVA) dropping from 6/6 (0.0 logMAR) to 6/18 (0.48 logMAR). She had no past ophthalmic history and was phakic. Spectral-domain optical coherence tomography (SD-OCT) revealed VMA with an underlying macular hole with no associated epiretinal membrane (Figure 1(a)). One week following an uncomplicated intravitreal ocriplasmin injection (125 µg in 0.10 mL), her BCVA was 6/60 (1.0 logMAR). Repeat SD-OCT revealed an enlarged full thickness macular hole (FTMH) with VMA release (Figure 1(b)). 35 days after injection, BCVA was 6/60 (0.92 logMAR) with a persistent enlarged FTMH (Figure 1(c)).

Bottom Line: Ocriplasmin is a protease which has been approved for the treatment of symptomatic vitreomacular adhesion (VMA).A 63-year-old presented with blurred vision in the left eye and a best corrected visual acuity of 6/18.This persisted at 1 month after the injection.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Western Eye Hospital, London NW1 5QH, UK ; Moorfields Eye Hospital, London EC1V 2PD, UK.

ABSTRACT
Ocriplasmin is a protease which has been approved for the treatment of symptomatic vitreomacular adhesion (VMA). A 63-year-old presented with blurred vision in the left eye and a best corrected visual acuity of 6/18. Optical coherence tomography revealed VMA with an underlying macular hole and she subsequently underwent a left intravitreal ocriplasmin injection. One week after the injection, VMA had been released but with enlargement of the macular hole and a drop in her BCVA to 6/60. This persisted at 1 month after the injection. It is important to warn patients that ocriplasmin may lead to an enlargement of their macular hole with resultant loss in visual acuity.

No MeSH data available.


Related in: MedlinePlus