Does ocriplasmin affect the RPE-photoreceptor adhesion in macular holes?
BACKGROUND
To evaluate the anatomical outcome of patients after vitrectomy due to persisting symptomatic vitreomacular traction (VMT), including full-thickness macular holes (FTMHs) of less than 400 µm, after ocriplasmin treatment.


METHODS
Retrospective, single centre, consecutive interventional case series. Patients were treated with a single intravitreal injection of ocriplasmin (Jetrea, Thrombogenics Inc, USA, Alcon/Novartis EU).


METHODS
resolution of VMT, closure of FTMH and anatomical outcome of vitrectomy after unsuccessful treatment with ocriplasmin.


RESULTS
Five patients were treated with ocriplasmin injection. VMT persisted in all but one case. Four patients underwent pars-plana vitrectomy (PPV) for treatment of persistent VMT and FTMH (n=2, size of macular hole <400 µm) in spectral-domain optical coherence tomography (SD-OCT). FTMHs were closed in both cases within the first week postoperatively. After PPV, in three eyes newly developed subretinal fluid was detected, which persisted up to several months postoperatively.


CONCLUSIONS
Data on ocriplasmin remain controversial. We report on four cases with resolution of VMT following PPV after unsuccessful ocriplasmin treatment. Newly developed subretinal fluid has been described after ocriplasmin treatment, predominantly in cases with resolution of VMT. We also detected this newly developed subretinal fluid after vitrectomy, which persisted for several weeks up to 7 months in two cases with FTMHs. This may be attributable to loosening of the photoreceptor complex due to enzyme activity of ocriplasmin. Long-term effects of ocriplasmin are still to be evaluated using SD-OCT.
Department of Ophthalmology, Charite -Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany.
A
A
Hager
Department of Ophthalmology, Charite -Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany.
I
I
Seibel
Department of Ophthalmology, Charite -Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany.
A
A
Riechardt
Department of Ophthalmology, Charite -Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany.
M
M
Rehak
Department of Ophthalmology, Charite -Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany.
A M
AM
Joussen
D000368:Aged; D001485:Basement Membrane / Q000601:surgery; D058450:Endotamponade; D005260:Female; D005341:Fibrinolysin / Q000627:therapeutic use*; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D008875:Middle Aged; D010446:Peptide Fragments / Q000627:therapeutic use*; D020419:Photoreceptor Cells, Vertebrate / Q000378:metabolism*; D012167:Retinal Perforations / Q000188:drug therapy* / Q000378:metabolism / Q000601:surgery; D055213:Retinal Pigment Epithelium / Q000378:metabolism*; D012189:Retrospective Studies; D058471:Subretinal Fluid; D000267:Tissue Adhesions / Q000188:drug therapy / Q000378:metabolism; D041623:Tomography, Optical Coherence; D014792:Visual Acuity; D014821:Vitrectomy; D020255:Vitreous Detachment / Q000209:etiology
D005343:Fibrinolytic Agents; D010446:Peptide Fragments; C054561:microplasmin; D005341:Fibrinolysin
Macula; Retina; Vitreous