Treatment outcomes and spectral-domain optical coherence tomography findings of eyes with symptomatic vitreomacular adhesion treated with intravitreal ocriplasmin

Abstract

Purpose: To determine treatment outcomes of intravitreal ocriplasmin in symptomatic vitreomacular adhesion.

Design: Retrospective interventional case series.

Methods: setting: Private practice. study population: Thirty-five eyes (35 subjects) with symptomatic vitreomacular adhesion. intervention/observation: Intravitreal ocriplasmin injection from February to November 2013. main outcome measure: Vitreomacular adhesion resolution rate. Secondary endpoints included postinjection visual acuity and rates of outer retinal attenuation and full-thickness macular hole (MH) closure.

Results: The 35 subjects included were of mean age 69 years, 66% female, and 71% phakic. Eleven subjects (31%) had macular comorbidities. Average adhesion diameter was 571 μm, with mean 7.9 months duration of symptoms. Nine subjects (26%) had epiretinal membrane and 6 (17%) had MH (mean diameter 186 μm). Mean preinjection logarithm of the minimal angle of resolution visual acuity was 0.46, and improved to 0.33 at final follow-up. Fifteen eyes (43%) achieved adhesion release at mean 10 days post injection. One of 6 MH (17%) closed. Transient outer retinal attenuation occurred in 10 of 35 cases (29%), with 8 of 10 (80%) achieving adhesion release. One subject (3%) developed a retinal detachment. Adhesion resolution was more likely in patients with younger age (P = .04), absence of comorbidities (P = .02), small adhesion diameter (P = .005), short adhesion duration (P = .03), and transient outer retinal attenuation (P = .008).

Conclusions: Intravitreal ocriplasmin efficacy in the private practice setting, while including patients with macular comorbidities, is similar to that of previous studies. Transient toxicity to the outer retina occurs frequently-typically with adhesion resolution-necessitating careful postinjection spectral-domain optical coherence tomography monitoring.