OCRIPLASMIN FOR VITREOMACULAR TRACTION: LOOKING OUTSIDE THE MACULA: A Wide-Field Optical Coherence Tomography Study

Retina. 2018 Aug;38(8):1541-1548. doi: 10.1097/IAE.0000000000001785.

Abstract

Purpose: To evaluate baseline features and morphologic changes of vitreoretinal adhesion and outer retinal layers outside the macula after intravitreal ocriplasmin injection. To study the relation between vitreous detachment and attenuation of retinal outer segments signal.

Methods: Retrospective cases series of 15 eyes. Each eye was scanned with the 55° wide-field optical coherence tomography lens in 6 different locations, three horizontal B-scan (central, temporal, and nasal) and three vertical B-scan (central, superior, and inferior) at baseline, 1 week, 1 month, 3 months, and 6 months after injection.

Results: After ocriplasmin injection, vitreomacular traction (VMT) resolved in 12 patients (80%), 3 of them presenting a complete posterior vitreous detachment. Eight patients (53%) showed a panretinal attenuation of photoreceptors outer segment signal, 7 with VMT resolution and 1 with non-posterior vitreous detachment and no VMT resolution. In three patients after VMT resolution the attenuation involved also areas with no posterior vitreous detachment. The attenuation resolved during follow-up in 7/8 eyes (87.5%).

Conclusion: Intravitreal ocriplasmin injection induced resolution of VMT in most cases and more rarely a release of vitreopapillary adhesion and a complete posterior vitreous detachment. An acute panretinopathy was visible in more than half of the patients and was not related to vitreous detachment.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Female
  • Fibrinolysin / therapeutic use*
  • Fibrinolytic Agents / therapeutic use*
  • Humans
  • Intravitreal Injections
  • Male
  • Middle Aged
  • Peptide Fragments / therapeutic use*
  • Retina / diagnostic imaging
  • Retina / pathology*
  • Retrospective Studies
  • Tomography, Optical Coherence / methods
  • Visual Acuity
  • Vitreous Detachment / diagnostic imaging
  • Vitreous Detachment / drug therapy*
  • Vitreous Detachment / pathology

Substances

  • Fibrinolytic Agents
  • Peptide Fragments
  • microplasmin
  • Fibrinolysin