Italian real-life experience on the use of ocriplasmin

Abstract

Objective: To evaluate the success of an intravitreal injection of ocriplasmin to release symptomatic vitreomacular traction (VMT) and close a full-thickness macular hole.

Methods and analysis: An observational retrospective multicentre study conducted in Italy. Patients with symptomatic distortion and loss of vision secondary to VMT were included in the study. The patients received a single injection of ocriplasmin and were followed up for 1, 3 and 6 months. Best-corrected visual acuity (BCVA) and spectral domani OCT (SD-OCT) were performed for patient assessment, and adverse events were recorded and analysed.

Results: 74 patients (74 eyes) were included in the study. 44 of 74 eyes (59.5%) experienced complete release of the VMT. Macular hole closure was obtained in eight eyes (40%). BCVA improved about three lines after 3 months of follow-up in the patients with VMT resolution in comparison with the patients who did not have VMT resolution (p<0.0001). In 55/74 eyes of 55 patients (74.3%), no adverse events were reported, and most of them were transitory (17/19; 89.5%). The mean time to resolve VMT was 27.4±21.9 days. No cases of retinal tear, retinal detachment or lens destabilisation were observed.

Conclusion: Ocriplasmin is a potential alternative treatment for patients with symptomatic VMT and has a good safety profile. A more careful selection of patients, in clinical practice, may increase the success rate.

Keywords: retina; treatment medical; treatment other; treatment surgery; visual perception; vitreous.

Figure 1

Histogram presenting the distribution of Vitreo-macular traction  (VMA) extension by surgical success outcome.

Figure 2

Boxplots of logMAR visual acuity at baseline and at 1, 3 and 6 months by surgical success outcome.

Figure 3

(A, E, I and O): OCT images show vitreomacular traction (extension 950 µm) at the baseline (A); 1 day after ocriplasmin injection (E); 1 month after ocriplasmin injection (I); and 6 months after ocriplasmin injection (O). Successful case. (B, F, L and P): OCT scans show an evident vitreomacular traction (extension 329 µm) with a full-thickness macular hole (diameter 82 µm) at the baseline (B); 1 month after ocriplasmin injection (F); 3 months after ocriplasmin injection (L); and 6 months after ocriplasmin injection (P). Successful case. (C, G, M and Q): OCT images show vitreomacular traction (extension 318 µm) at the baseline (C); 1 day after ocriplasmin injection (G); 1 month after ocriplasmin injection (M); and 6 months after ocriplasmin injection (Q). Successful case. (D and H): OCT scans show vitreomacular traction (extension 700 µm) at the baseline (D) and 2 months after ocriplasmin injection (H). Unsuccessful case. (N and R): OCT images show vitreomacular traction (extension 538 µm) at the baseline (N) and 6 months after ocriplasmin injection (R). Unsuccessful case. OCT, optical coherence tomography.

Figure 4

Scatterplot of baseline (x-axis) versus 3-month (y-axis) logMAR visual acuity. Eyes with surgical success are presented as light grey diamonds and those with no success are dark grey dots. Values above the diagonal (dashed) line are improved compared with baseline.