INTRAVITREAL OCRIPLASMIN IN CLINICAL PRACTICE

Predictors of Success, Visual Outcomes, and Complications

Henry L. Feng, Daniel B. Roth, Aisha Hasan, Howard F. Fine, Matthew M. Wheatley, Jonathan L. Prenner, Sumit P. Shah, Kunjal K. Modi, William J Feuer

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
JournalRetina
DOIs
StateAccepted/In press - Jan 18 2017

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Traction
Retinal Perforations
Visual Acuity
Optical Coherence Tomography
microplasmin
Comorbidity
Anatomy

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Feng, H. L., Roth, D. B., Hasan, A., Fine, H. F., Wheatley, M. M., Prenner, J. L., ... Feuer, W. J. (Accepted/In press). INTRAVITREAL OCRIPLASMIN IN CLINICAL PRACTICE: Predictors of Success, Visual Outcomes, and Complications. Retina. https://doi.org/10.1097/IAE.0000000000001505

INTRAVITREAL OCRIPLASMIN IN CLINICAL PRACTICE : Predictors of Success, Visual Outcomes, and Complications. / Feng, Henry L.; Roth, Daniel B.; Hasan, Aisha; Fine, Howard F.; Wheatley, Matthew M.; Prenner, Jonathan L.; Shah, Sumit P.; Modi, Kunjal K.; Feuer, William J.

In: Retina, 18.01.2017.

Research output: Contribution to journalArticle

Feng, HL, Roth, DB, Hasan, A, Fine, HF, Wheatley, MM, Prenner, JL, Shah, SP, Modi, KK & Feuer, WJ 2017, 'INTRAVITREAL OCRIPLASMIN IN CLINICAL PRACTICE: Predictors of Success, Visual Outcomes, and Complications', Retina. https://doi.org/10.1097/IAE.0000000000001505
Feng, Henry L. ; Roth, Daniel B. ; Hasan, Aisha ; Fine, Howard F. ; Wheatley, Matthew M. ; Prenner, Jonathan L. ; Shah, Sumit P. ; Modi, Kunjal K. ; Feuer, William J. / INTRAVITREAL OCRIPLASMIN IN CLINICAL PRACTICE : Predictors of Success, Visual Outcomes, and Complications. In: Retina. 2017.
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abstract = "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.",
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T2 - Predictors of Success, Visual Outcomes, and Complications

AU - Feng, Henry L.

AU - Roth, Daniel B.

AU - Hasan, Aisha

AU - Fine, Howard F.

AU - Wheatley, Matthew M.

AU - Prenner, Jonathan L.

AU - Shah, Sumit P.

AU - Modi, Kunjal K.

AU - Feuer, William J

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N2 - 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.

AB - 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.

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