Limits...
Incomplete vitreomacular traction release using intravitreal ocriplasmin.

Chin EK, Almeida DR, Sohn EH, Boldt HC, Mahajan VB, Gehrs KM, Russell SR, Folk JC - Case Rep Ophthalmol (2014)

Bottom Line: The average age was 78.4 years (range: 63-92).The mean follow-up period for those who did not undergo vitrectomy was 9 months (range: 1-13).There was an associated reduction in VA after ocriplasmin treatment at 1 month of follow-up.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.

ABSTRACT

Purpose: To report the clinical course of our first 7 consecutive patients treated with intravitreal ocriplasmin (Jetrea(®)).

Methods: Retrospective case series of the first 7 patients treated with ocriplasmin between January and December 2013 at an academic tertiary care center.

Results: The average age was 78.4 years (range: 63-92). Five patients were pseudophakic and 2 patients were phakic in the injected eye. The median baseline visual acuity (VA) was 20/60 (range: 20/25 to 20/200). The median 1-month postinjection VA was 20/70, with a mean loss of 2 lines of VA among all patients. None of the patients had complete resolution of their vitreomacular traction or macular hole at 1 month of follow-up. Three patients had subsequent pars plana vitrectomy and membrane peeling surgery. The mean follow-up period for those who did not undergo vitrectomy was 9 months (range: 1-13). One patient with known ocular hypertension had an increase in intraocular pressure requiring topical pressure-lowering eyedrops. There were no cases of postinjection uveitis, endophthalmitis, retinal tears, or retinal detachment.

Conclusions: While ocriplasmin may be a viable pharmacological agent for vitreolysis, we present a series of patients that all had incomplete resolution of vitreomacular traction with and without full-thickness macular hole. There was an associated reduction in VA after ocriplasmin treatment at 1 month of follow-up. Careful analysis of the vitreoretinal interface and comorbid eye conditions is required to optimize outcome success with ocriplasmin.

No MeSH data available.


Related in: MedlinePlus

a–d Patient No. 3. a Focal VMA with a few small intraretinal cysts. b Broad VMA that can only be seen in horizontal scans. Superficial cysts are present just below the internal limiting membrane. c Focal VMA with a new small amount of subretinal fluid 1 month after ocriplasmin. d Unchanged broad VMA temporally, but resolution of the intraretinal superficial cysts 1 month after ocriplasmin.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4296250&req=5

Figure 2: a–d Patient No. 3. a Focal VMA with a few small intraretinal cysts. b Broad VMA that can only be seen in horizontal scans. Superficial cysts are present just below the internal limiting membrane. c Focal VMA with a new small amount of subretinal fluid 1 month after ocriplasmin. d Unchanged broad VMA temporally, but resolution of the intraretinal superficial cysts 1 month after ocriplasmin.

Mentions: (2) Broad versus Focal Vitreomacular Attachments. We observed 2 patients with broad vitreoretinal adhesions (patient No. 2, fig. 1c, d; patient No. 3, fig. 2b, d) which did not change significantly following intravitreal ocriplasmin. Both these patients went on to develop new trace subretinal fluid and slight worsening of their vision. Interestingly, even those with focal adhesions tended to do poorly in this series. In some cases, the adhesion may have been so strong that the vitreolysis caused increased intraretinal or subretinal fluid, as well as transient subjective and objective blurring in the interim prior to their 1-month follow-up. In a majority of cases, the trace subretinal fluid and/or intraretinal cysts at the fovea center at 1 month of follow-up eventually resolved; however, the VMT or VMA persisted.


Incomplete vitreomacular traction release using intravitreal ocriplasmin.

Chin EK, Almeida DR, Sohn EH, Boldt HC, Mahajan VB, Gehrs KM, Russell SR, Folk JC - Case Rep Ophthalmol (2014)

a–d Patient No. 3. a Focal VMA with a few small intraretinal cysts. b Broad VMA that can only be seen in horizontal scans. Superficial cysts are present just below the internal limiting membrane. c Focal VMA with a new small amount of subretinal fluid 1 month after ocriplasmin. d Unchanged broad VMA temporally, but resolution of the intraretinal superficial cysts 1 month after ocriplasmin.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4296250&req=5

Figure 2: a–d Patient No. 3. a Focal VMA with a few small intraretinal cysts. b Broad VMA that can only be seen in horizontal scans. Superficial cysts are present just below the internal limiting membrane. c Focal VMA with a new small amount of subretinal fluid 1 month after ocriplasmin. d Unchanged broad VMA temporally, but resolution of the intraretinal superficial cysts 1 month after ocriplasmin.
Mentions: (2) Broad versus Focal Vitreomacular Attachments. We observed 2 patients with broad vitreoretinal adhesions (patient No. 2, fig. 1c, d; patient No. 3, fig. 2b, d) which did not change significantly following intravitreal ocriplasmin. Both these patients went on to develop new trace subretinal fluid and slight worsening of their vision. Interestingly, even those with focal adhesions tended to do poorly in this series. In some cases, the adhesion may have been so strong that the vitreolysis caused increased intraretinal or subretinal fluid, as well as transient subjective and objective blurring in the interim prior to their 1-month follow-up. In a majority of cases, the trace subretinal fluid and/or intraretinal cysts at the fovea center at 1 month of follow-up eventually resolved; however, the VMT or VMA persisted.

Bottom Line: The average age was 78.4 years (range: 63-92).The mean follow-up period for those who did not undergo vitrectomy was 9 months (range: 1-13).There was an associated reduction in VA after ocriplasmin treatment at 1 month of follow-up.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.

ABSTRACT

Purpose: To report the clinical course of our first 7 consecutive patients treated with intravitreal ocriplasmin (Jetrea(®)).

Methods: Retrospective case series of the first 7 patients treated with ocriplasmin between January and December 2013 at an academic tertiary care center.

Results: The average age was 78.4 years (range: 63-92). Five patients were pseudophakic and 2 patients were phakic in the injected eye. The median baseline visual acuity (VA) was 20/60 (range: 20/25 to 20/200). The median 1-month postinjection VA was 20/70, with a mean loss of 2 lines of VA among all patients. None of the patients had complete resolution of their vitreomacular traction or macular hole at 1 month of follow-up. Three patients had subsequent pars plana vitrectomy and membrane peeling surgery. The mean follow-up period for those who did not undergo vitrectomy was 9 months (range: 1-13). One patient with known ocular hypertension had an increase in intraocular pressure requiring topical pressure-lowering eyedrops. There were no cases of postinjection uveitis, endophthalmitis, retinal tears, or retinal detachment.

Conclusions: While ocriplasmin may be a viable pharmacological agent for vitreolysis, we present a series of patients that all had incomplete resolution of vitreomacular traction with and without full-thickness macular hole. There was an associated reduction in VA after ocriplasmin treatment at 1 month of follow-up. Careful analysis of the vitreoretinal interface and comorbid eye conditions is required to optimize outcome success with ocriplasmin.

No MeSH data available.


Related in: MedlinePlus