Short-term changes in posterior vitreous cortex following intravitreal ocriplasmin for symptomatic vitreomacular traction syndrome: a prospective study

Int Ophthalmol. 2020 Jan;40(1):185-193. doi: 10.1007/s10792-019-01177-7. Epub 2019 Sep 29.

Abstract

Purpose: To describe and analyze short-term posterior vitreous abnormalities following intravitreal ocriplasmin in eyes with symptomatic vitreomacular traction syndrome (VMT).

Methods: In this institutional, prospective and interventional study enrolled patients with symptomatic focal VMT syndrome treated with intravitreal ocriplasmin. In all cases, spectral-domain optical coherence tomography scans were quantitatively and qualitatively analyzed preoperatively and at 1 and 4 weeks postoperatively.

Results: Twenty-three patients, of which 5 were males and 18 females, with a mean age of 69.5 ± 8.2 years were included in this study. Postoperatively, VMT resolved in 11 of 23 eyes (47.8%). In 9 out of 11 cases (81.8%), VMT resolved by postoperative week 1, whether in the remaining 2 (18.2%) anatomical restoration, was diagnosed at postoperative week 4. At postoperative week 1, a foveolar detachment was detected in 9 out of 23 eyes (39.1%). The foveolar detachment resolved all but one eye by the end of postoperative week 4. At the end of the follow-up period, the presence of subretinal fluid was detected in 7 out of 9 eyes (77.8%), and it was significantly associated with a shrinkage of the posterior vitreous cortex (p < 0.006). At the end of the follow-up period, visual acuity was significantly higher in those eyes with VMT resolution (p < 0.001).

Conclusion: Intravitreal ocriplasmin is effective for the treatment of patients with VMT. The postoperative presence of posterior hyaloid shrinkage may be associated with higher traction over the foveal area and the appearance of foveolar detachment.

Keywords: Intravitreal injection; Ocriplasmin; Subretinal fluid; Vitreomacular traction syndrome.

MeSH terms

  • Aged
  • Female
  • Fibrinolysin / administration & dosage*
  • Follow-Up Studies
  • Humans
  • Intravitreal Injections
  • Male
  • Middle Aged
  • Peptide Fragments / administration & dosage*
  • Prospective Studies
  • Retinal Perforations / diagnosis
  • Retinal Perforations / drug therapy*
  • Syndrome
  • Time Factors
  • Tomography, Optical Coherence / methods*
  • Treatment Outcome
  • Visual Acuity*
  • Vitreous Body / pathology*
  • Vitreous Detachment / diagnosis
  • Vitreous Detachment / drug therapy*

Substances

  • Peptide Fragments
  • microplasmin
  • Fibrinolysin