INTRAVITREAL OCRIPLASMIN IN CLINICAL PRACTICE
Autor: | Sumit P Shah, Kunjal K Modi, Daniel B. Roth, H. Matthew Wheatley, Henry L Feng, Howard F Fine, William J. Feuer, Aisha Hasan, Jonathan L. Prenner |
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Rok vydání: | 2018 |
Předmět: |
Male
medicine.medical_specialty Visual acuity genetic structures Visual Acuity Tissue Adhesions Subgroup analysis Vitreomacular traction Vitreous Detachment 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine medicine Humans Fibrinolysin Macular hole Aged Retrospective Studies business.industry Ocriplasmin Retinal General Medicine Retinal Perforations medicine.disease Vitreomacular adhesion Peptide Fragments eye diseases Surgery Clinical Practice Ophthalmology Treatment Outcome chemistry Intravitreal Injections 030221 ophthalmology & optometry Female sense organs medicine.symptom business Tomography Optical Coherence 030217 neurology & neurosurgery Follow-Up Studies |
Zdroj: | Retina. 38:128-136 |
ISSN: | 0275-004X |
Popis: | PURPOSE To investigate predictors of success, visual outcomes, and complications of intravitreal ocriplasmin for the treatment of symptomatic vitreomacular adhesion in a clinical care setting. METHODS Retrospective chart review of 49 consecutive eyes of 47 patients who received intravitreal ocriplasmin. Spectral domain optical coherence tomography scans were examined for vitreomacular traction (VMT) release, full-thickness macular hole (FTMH) closure, and other changes in retinal anatomy. RESULTS Pharmacologic VMT release occurred in 41% of eyes; positive predictors included age ≤75 years (P = 0.001), phakic status (P = 0.016), VMT width ≤750 μm (P = 0.001), and absence of retinal comorbidities (P = 0.035). Pharmacologic FTMH closure occurred in 25% of cases; positive predictors included successful VMT release (P = 0.042), better preinjection best-corrected visual acuity (P = 0.036), and smaller FTMH aperture width (P = 0.033). Eyes that achieved VMT release and did not undergo surgery attained significant improvement in best-corrected visual acuity (P = 0.015). Complications included subfoveal lucency (33%), ellipsoid zone disruption (33%), and FTMH base enlargement (75%). Only FTMH base enlargement resulted in worse visual outcomes (P = 0.024). Subgroup analysis of 14 eyes with ideal characteristics (all positive predictors listed above) yielded a 93% VMT release rate. CONCLUSION Proper case selection may facilitate successful pharmacologic vitreolysis with ocriplasmin, improve visual outcomes, and minimize potential complications. |
Databáze: | OpenAIRE |
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