Session Title: Miscellaneous
Session Date/Time: Saturday 13/09/2014 | 11:00-13:00
Paper Time: 11:16
Venue: Boulevard E
First Author: : P.Kaiser USA
Co Author(s): : Y. Ito S. Srivistava J. Ehlers
Intravitreal ocriplasmin is approved for the treatment of patients with symptomatic vitreomacular adhesion (sVMA; considered equivalent to vitreomacular traction). This case series will outline the efficacy and safety of ocriplasmin based on ‘real-world’ clinical experience.
Patients with vitreomacular traction (including those with macular hole; MH) who were treated with ocriplasmin at the Cole Eye Institute, Cleveland Clinic, US, were included in this retrospective case series.
Clinical outcomes for patients who received an intravitreal injection of ocriplasmin between March 2013 and June 2013 were analysed. Parameters evaluated included: baseline demographics and clinical characteristics; proportion of patients achieving VMA release and MH closure; change in best-corrected visual acuity (BCVA); and the occurrence of visual symptoms.
A total of 19 patients (five male; 14 female) with a mean age of 69.6 ± 7.8 years were included in the analysis. On average, patients had experienced symptoms for a mean of 6.1 ± 6.2 months before treatment, and the mean baseline BCVA was logMAR 0.32 ± 0.11. Twelve patients (63%) were phakic, seven patients (37%) were pseudophakic and five patients (26%) had an epiretinal membrane (ERM) at baseline. At Month 3 after injection, 8/18 patients (44%) achieved resolution of VMA and 5/8 patients (63%) achieved MH closure. One case was excluded from the analysis since no traction was evident at baseline. The mean BCVA decreased to logMAR 0.36 at Day 7 after injection; however, this effect appeared to be transient and, by Month 3, the mean BCVA had increased to logMAR 0.23. In total, 9/19 patients (47%) experienced some reductions in visual acuity over the 3-month post-injection period all of which resolved. Other visual symptoms included photopsia (10/19; 53%), changes in colour or brightness (7/19; 37%) and blurred vision (9/19; 47%).
These findings demonstrate the successful use of ocriplasmin in a small sample of patients, with higher rates of VMA release and MH closure than those reported in the ocriplasmin phase III clinical trials. Furthermore, observed anatomical resolution was associated with improvements patient BCVA. Appropriate patient selection may have contributed to the observed treatment success. Further ‘real-world’ clinical experience with ocriplasmin will elucidate the impact of patient selection on clinical outcomes.