Predicting the individual probability of macular hole closure following intravitreal ocriplasmin injections for vitreomacular traction release using baseline characteristics

Thomas Bertelmann; Lars Berndzen; Thomas Raber; Sebastian Pfeiffer; Andreas Leha; Christoph Paul; Nicolas Feltgen; Sebastian Bemme

doi:10.1038/s41598-021-03509-z

Predicting the individual probability of macular hole closure following intravitreal ocriplasmin injections for vitreomacular traction release using baseline characteristics

Sci Rep. 2021 Dec 16;11(1):24096. doi: 10.1038/s41598-021-03509-z.

Authors

Thomas Bertelmann¹, Lars Berndzen², Thomas Raber³, Sebastian Pfeiffer⁴, Andreas Leha⁵, Christoph Paul⁶, Nicolas Feltgen², Sebastian Bemme²

Affiliations

¹ Department of Ophthalmology, University Medical Center Goettingen, Robert-Koch-Straße 40, 37075, Goettingen, Germany. thomas.bertelmann@med.uni-goettingen.de.
² Department of Ophthalmology, University Medical Center Goettingen, Robert-Koch-Straße 40, 37075, Goettingen, Germany.
³ Oxurion NV, Leuven, Belgium.
⁴ UMG Study Center, University Medical Center Goettingen, Goettingen, Germany.
⁵ Department of Medical Biometry and Statistical Bioinformatics, University Medical Center Goettingen, Goettingen, Germany.
⁶ Department of Ophthalmology, Philipps-University Marburg, Marburg, Germany.

Abstract

The primary objective was to create and establish a new formula that predicts the individual probability of macular hole closure for eyes with full thickness macular holes (FTMH) accompanied by vitreomacular traction (VMT) which received enzymatic vitreolysis using intravitreally administered ocriplasmin. The secondary objective was to evaluate the forecast reliability of a previously published formula for VMT resolution in VMT-only eyes (Odds_IVO-Success = e^Intercept× OR^years× OR^ln(µm); Probability_IVO-Success = Odds_IVO-Success/(Odds_IVO-Success + 1)) on VMT resolution using the current dataset of eyes with FTMH accompanied by VMT. Retrospective analysis of the OASIS, ORBIT, and INJECT-studies. Patients with FTMH and VMT with complete information (n = 213) were included. The effect of gender, age, FTMH diameter, lens status and the presence of epiretinal membranes (ERM) on FTMH closure was assessed using separate univariate logistic regression analyses. With regard to VMT release separate univariate regression analyses were carried out and results were compared with formerly published data of VMT resolution in eyes with VMT only. Overall, 126 eyes (63%) experienced VMT resolution within 28 days. Younger age (p < 0.0001) and VMT diameter (p = 0.041) had a significant impact on VMT release. Overall, 81 eyes (38%) treated with ocriplasmin showed FTMH closure within 28 days. Univariate analysis of the different predictors analyzed revealed that FTMH diameter < 250 µm had a significant impact on treatment success (p = 0.0495). It was not possible to calculate and establish a new multivariate formula that can predict the individual FTMH closure probability for eyes with FTMHs and VMT. However, the results of VMT release prediction in eyes with FTMHs accompanied by VMT matched the prediction of VMT release in eyes with VMT only when using the previously published formula. All in all, predictors for calculating the individual probability of VMT resolution on the one hand and FTMH closure on the other hand are different suggesting diverse pathophysiological mechanisms.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Aged, 80 and over
Female
Fibrinolysin / administration & dosage*
Forecasting
Humans
Intravitreal Injections
Male
Middle Aged
Peptide Fragments / administration & dosage*
Probability
Retinal Perforations / drug therapy*
Retinal Perforations / etiology
Retrospective Studies
Treatment Outcome
Vitrectomy / methods
Vitreous Detachment / complications
Vitreous Detachment / drug therapy*

Substances

Peptide Fragments
microplasmin
Fibrinolysin