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The Portuguese experience with ocriplasmin in clinical practice

Session Details

Session Title: Vitreoretinal Surgery V

Session Date/Time: Sunday 20/09/2015 | 11:00-13:00

Paper Time: 12:52

Venue: Hermes

First Author: : J.Figueira PORTUGAL

Co Author(s): :    D. Martins   A. Sampaio   J. Nascimento   A. Carneiro   A. Meireles   N. Ferreira

Abstract Details

PURPOSE:To determine the anatomical and functional outcomes in patients submitted to intravitreal injection of ocriplasmin in Portugal for the treatment of vitreomacular traction (VMT)

Setting:

Multicenter Study of Portuguese Ocriplasmin Users

Methods:

All users of ocriplasmin in Portugal were invited to participate in this multicentre, retrospective interventional study. Only patients that received intravitreal ocriplasmin for focal VMT (< 1500 µm) with or without full-thickness macular hole (FTMH) with less than 400 µm diameter were included. VMT release, full-thickness MH closure, visual acuity changes, anatomical characteristics on spectral domain optical coherence tomography (SD-OCT) of the injected/fellow eye, and safety of the treatment were analysed.

Results:

A total of 46 eyes from 44 patients were included, representing 78% of total ocriplasmin injections in Portugal, according to Alcon data. Median follow-up was 39 days (min. 7; max. 304). VMT resolved in 23 of 46 eyes (50%) and nonsurgical closure of FTMH was achieved in 3 of 8 eyes (37.5%). Mean improved of BCVA among all treated eyes from baseline to last follow-up visit was + 3,9 letters (p = 0,03). The baseline characteristics more frequently associated with VMT resolution were: presence of intra-retinal fluid/cysts (p=0,011) and VMT adhesion length (p=0,037). Transient ellipsoid zone changes were noted in 40% of treated eyes and transient subfoveal fluid accumulation was noted in all eyes with vitreomacular release. The fellow eye presented an interface pathology in 13 (28.3%) of the cases, with isolated VMT in 10 and VMT with FTMH in 3. The more frequent complains reported were: pain /discomfort (39,5%), photopsia and/or myodesopsia (10.5%), transient vision loss 7.8% (n=3). One patient developed intraocular hypertension and other uveitis, both controlled with topical treatment.

Conclusions:

In this Portuguese series of “real word” use of ocriplasmin, the success rate of VMT resolution after enzimatic vitreolysis was 50%. There was a significant improvement in mean BCVA, with a mean gain of 3.9 letters. The treatment seems to be safe with only one case of transitory intraocular hypertension and other with uveitis. In our opinion a careful selection of patients is fundamental to optimize the results with the use of ocriplasmin.

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