title: Improved efficacy of ocriplasmin for vitreomacular traction release and transient changes in optic disk morphology.
abstract: OBJECTIVE
  To determine the efficacy and safety of ocriplasmin for vitreomacular traction (VMT) resolution and to study changes in optic disk and peripapillary region.
  
  
  METHODS
  Retrospective, single-center, observational case series. In 38 eyes with VMT (10 with concomitant full-thickness macular hole), determined by optical coherence tomography, a single intravitreal injection of ocriplasmin was administered. Baseline ocular characteristics included the presence/absence of epiretinal membrane, lens status, and vitreomacular adhesion size. Spectral domain optical coherence tomography and Heidelberg retinal tomography were performed at baseline and follow-up visits.
  
  
  RESULTS
  A total of 71.1% of eyes treated with ocriplasmin had VMT resolution, improving to 83.9% after applying MIVI-TRUST selection criteria. A total of 90% of eyes with full-thickness macular hole showed VMT resolution, with 40% of those achieving full-thickness macular hole closure. Subretinal fluid in the macular region was observed in 36.8% of eyes 1 day after injection, and all cleared spontaneously by Day 42. A significant difference was observed in cup/disk area ratio between patients who achieved VMT resolution and patients who did not.
  
  
  CONCLUSIONS
  Careful patient selection improves ocriplasmin efficacy. Transient optic disk morphology changes such as decreased cup/disk area ratio may occur in patients without VMT resolution.
authors.affiliation: *Department of Ophthalmology, University Hospitals Leuven, Leuven, Belgium; and †Department of Ophthalmology, Centro Hospitalar Lisboa Norte, Lisbon, Portugal and Institute of Pharmacology and Neurosciences, Faculty of Medicine, Lisbon University, Lisbon, Portugal.
authors.forename: Koen
authors.initials: K
authors.lastname: Willekens
authors.forename: Luís
authors.initials: L
authors.lastname: Abegão Pinto
authors.forename: Evelien
authors.initials: E
authors.lastname: Vandewalle
authors.forename: Ingeborg
authors.initials: I
authors.lastname: Stalmans
authors.forename: Peter
authors.initials: P
authors.lastname: Stalmans
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005128:Eye Diseases / Q000175:diagnosis / Q000188:drug therapy*; D005260:Female; D005341:Fibrinolysin / Q000009:adverse effects / Q000627:therapeutic use*; D005343:Fibrinolytic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D008875:Middle Aged; D009898:Optic Disk / Q000473:pathology*; D018579:Patient Selection; D010446:Peptide Fragments / Q000009:adverse effects / Q000627:therapeutic use*; D012164:Retinal Diseases / Q000175:diagnosis / Q000188:drug therapy*; D012189:Retrospective Studies; D000267:Tissue Adhesions / Q000188:drug therapy; D016896:Treatment Outcome; D014822:Vitreous Body / Q000187:drug effects* / Q000473:pathology
chemical_list: D005343:Fibrinolytic Agents; D010446:Peptide Fragments; C054561:microplasmin; D005341:Fibrinolysin