title: Treatment outcomes and spectral-domain optical coherence tomography findings of eyes with symptomatic vitreomacular adhesion treated with intravitreal ocriplasmin.
abstract: OBJECTIVE
  To determine treatment outcomes of intravitreal ocriplasmin in symptomatic vitreomacular adhesion.
  
  
  METHODS
  Retrospective interventional case series.
  
  
  METHODS
  setting: Private practice. study population: Thirty-five eyes (35 subjects) with symptomatic vitreomacular adhesion. intervention/observation: Intravitreal ocriplasmin injection from February to November 2013. main outcome measure: Vitreomacular adhesion resolution rate. Secondary endpoints included postinjection visual acuity and rates of outer retinal attenuation and full-thickness macular hole (MH) closure.
  
  
  RESULTS
  The 35 subjects included were of mean age 69 years, 66% female, and 71% phakic. Eleven subjects (31%) had macular comorbidities. Average adhesion diameter was 571 μm, with mean 7.9 months duration of symptoms. Nine subjects (26%) had epiretinal membrane and 6 (17%) had MH (mean diameter 186 μm). Mean preinjection logarithm of the minimal angle of resolution visual acuity was 0.46, and improved to 0.33 at final follow-up. Fifteen eyes (43%) achieved adhesion release at mean 10 days post injection. One of 6 MH (17%) closed. Transient outer retinal attenuation occurred in 10 of 35 cases (29%), with 8 of 10 (80%) achieving adhesion release. One subject (3%) developed a retinal detachment. Adhesion resolution was more likely in patients with younger age (P = .04), absence of comorbidities (P = .02), small adhesion diameter (P = .005), short adhesion duration (P = .03), and transient outer retinal attenuation (P = .008).
  
  
  CONCLUSIONS
  Intravitreal ocriplasmin efficacy in the private practice setting, while including patients with macular comorbidities, is similar to that of previous studies. Transient toxicity to the outer retina occurs frequently-typically with adhesion resolution-necessitating careful postinjection spectral-domain optical coherence tomography monitoring.
authors.affiliation: The Retina Group of Washington, Chevy Chase, Maryland; MedStar Washington Hospital Center, Washington, DC; Georgetown University School of Medicine, Washington, DC.
authors.forename: David J
authors.initials: DJ
authors.lastname: Warrow
authors.affiliation: The Retina Group of Washington, Chevy Chase, Maryland; MedStar Washington Hospital Center, Washington, DC; Georgetown University School of Medicine, Washington, DC. Electronic address: mikemlai@yahoo.com.
authors.forename: Michael M
authors.initials: MM
authors.lastname: Lai
authors.affiliation: MedStar Washington Hospital Center, Washington, DC; Georgetown University School of Medicine, Washington, DC.
authors.forename: Auvni
authors.initials: A
authors.lastname: Patel
authors.affiliation: Georgetown University School of Medicine, Washington, DC.
authors.forename: Joseph
authors.initials: J
authors.lastname: Raevis
authors.affiliation: The Retina Group of Washington, Chevy Chase, Maryland; MedStar Washington Hospital Center, Washington, DC; Georgetown University School of Medicine, Washington, DC.
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Berinstein
mesh_terms: D000368:Aged; D005260:Female; D005341:Fibrinolysin / Q000008:administration & dosage*; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D010446:Peptide Fragments / Q000008:administration & dosage*; D012164:Retinal Diseases / Q000188:drug therapy*; D012189:Retrospective Studies; D012307:Risk Factors; D000267:Tissue Adhesions / Q000188:drug therapy; D041623:Tomography, Optical Coherence; D014792:Visual Acuity
chemical_list: D005343:Fibrinolytic Agents; D010446:Peptide Fragments; C054561:microplasmin; D005341:Fibrinolysin