Skip to main content

  • Ocriplasmin for Symptomatic Vitreomacular Adhesion

    By Jean Shaw
    Selected By: Andrew P. Schachat, MD
    Add to My Bookmarks

    Journal Highlights

    Ophthalmology Retina, September/October 2017

    Download PDF

    Lim et al. evaluated the anatomic and visual outcomes in patients with symptomatic vitreomacular adhesion (VMA) who were treated with ocri­plasmin. They found that VMA had resolved with ocriplasmin alone in 83 of 191 eyes (43%) by week 12 and in 148 of 200 eyes (74%) by the last visit, including eyes that underwent pars plana vitrectomy (PPV).

    For this retrospective chart review, the authors surveyed members of the Macula Society online. Participating clinicians provided information for each eligible patient in their practice, data collection was open for 6 months, and no limit was placed on the length of follow-up. Information was collected on demographics, visual acuity (VA), extent of VMA, presence or absence of macular hole, and spectral-domain op­tical coherence tomography (SD-OCT) findings before and after treatment.

    All told, 31 investigators participated, contributing data on 208 patients (208 eyes). Of these, 52 (25%) had diabetes, 143 (69%) were female, and 175 (84%) were non-Hispanic whites. At baseline, all patients had symptomatic VMA, 75 (36%) had a full-thickness macular hole, and 41 (20%) had a lamellar hole. Mean VA at baseline was 20/63. The median follow-up was 166 days (range, 21-704 days).

    Release of VMA—regardless of whether the eye underwent subse­quent PPV—was observed as follows: 1) by the first week, in 70 of 161 eyes (44%); 2) by week 4, in 94 of 190 eyes (49%); 3) by week 12, in 111 of 191 eyes (58%); and 4) by the patient’s final visit, in 148 of 200 eyes (74%). In eyes treated with ocriplasmin alone, those results were 85 of 190 eyes (45%) at 4 weeks, 83 of 191 eyes (43%) at 12 weeks, and 90 of 200 eyes (45%) at the final visit.

    For eyes with a macular hole at baseline, closure was achieved with ocriplasmin alone in 35 of 64 eyes (55%) by the first week, 42 of 73 (58%) by 4 weeks, and in 30 of 75 (40%) by the last visit. With regard to VA, it had improved by ≥ 2 lines at the final visit in 69 eyes (35%) and by ≥ 3 lines in 54 eyes (27%)—but had decreased by ≥ 2 lines in 35 eyes (18%) and by ≥ 3 lines in 27 eyes (14%).

    Complications included photop­sias (15%), dimness of vision (14%), decreased color vision (10%), and macular hole development (5%).

    The original article can be found here.