Prospective three-dimensional analysis of structure and function in vitreomacular adhesion cured by pharmacologic vitreolysis.
OBJECTIVE
To prospectively characterize macular structure and function as assessed by combined three-dimensional spectral-domain optical coherence tomography and scanning laser ophthalmoscopy and 3D computer-automated threshold Amsler grid, respectively, in a patient undergoing pharmacologic vitreolysis for vitreomacular adhesion with tractional cysts.


METHODS
Combined 3D optical coherence tomography and scanning laser ophthalmoscopy measured macular volume and 3D computer-automated threshold Amsler grid quantified central visual field function by determining the absolute percent magnitude lost (cumulative value of total visual field loss over all tested levels) before and for a period of 6 months after pharmacologic vitreolysis for vitreomacular adhesion with a single intravitreal injection of microplasmin (125 μg; ThromboGenics).


RESULTS
Ocriplasmin pharmacologic vitreolysis released vitreomacular adhesion by 2 weeks and decreased macular volume from 0.32 μL to 0.15 μL by 1 year after injection. There was a concomitant 4-fold improvement in visual function as measured by 3D computer-automated threshold Amsler grid (percent of central visual field lost) and Snellen visual acuity improved from 20/200 to 20/40.


CONCLUSIONS
For assessing macular function improvement in conjunction with structural reintegration after pharmacologic vitreolysis for vitreomacular adhesion, 3D computer-automated threshold Amsler grid is a useful tool. Both 3D measurements quantitatively characterized the resolution of this patient's vitreomacular adhesion, suggesting that this is a useful approach to quantifying macular structure and function as indices of the severity of disease and the response to therapy.
*VMR Institute, Huntington Beach, California †Doheny Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, California ‡ECE Department §BME Department, and ¶Department of Ophthalmology and Vision Science, The University of Arizona, Tucson, Arizona **Division of Physics, Mathematics and Astronomy, California Institute of Technology, Pasadena, California.
Kevin R
KR
Tozer
Wolfgang
W
Fink
Alfredo A
AA
Sadun
Jerry
J
Sebag