Session Title: Vitreoretinal Surgery V
Session Date/Time: Sunday 20/09/2015 | 11:00-13:00
Paper Time: 12:52
First Author: : J.Figueira PORTUGAL
Co Author(s): : D. Martins A. Sampaio J. Nascimento A. Carneiro A. Meireles N. Ferreira
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)
Multicenter Study of Portuguese Ocriplasmin Users
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.
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.
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.