title: Outer retina reflectivity changes on sd-oct after intravitreal ocriplasmin for vitreomacular traction and macular hole.
abstract: OBJECTIVE
  To report initial experience with intravitreal ocriplasmin (IVO) and to describe outer retina reflectivity changes observed on spectral domain optical coherence tomography (SD-OCT) after IVO injection in patients with vitreomacular traction (VMT) with or without macular holes (MHs).
  
  
  METHODS
  A consecutive retrospective review of patients with VMT and MH who were treated with IVO was performed. Patients underwent complete ophthalmic evaluation, including nonstandardized Snellen visual acuity testing, and SD-OCT at baseline and follow-up visits.
  
  
  RESULTS
  A total of 23 patients who received IVO for VMT and/or MH were included for analysis. Patient age ranged from 53 years to 93 years with a mean of 74 years. The mean follow-up was 174 days (range: 20-291 days). Vitreomacular traction release at Day 30 after IVO was achieved in 11 of 23 patients (47.82%), at an average of 14.54 days (range: 1-30 days) after treatment. The mean visual acuity improved from 0.50 to 0.38. At presentation, eight patients had MH associated with VMT. Closure of the MH with ocriplasmin was achieved in two patients, and six patients underwent pars plana vitrectomy for MH repair. Ten of 23 patients (43.47%) presented with changes in the outer retina reflectivity on SD-OCT after IVO, 4 patients of this group experienced a decrease in visual acuity. In 7 of these 10 patients (70%), VMT release was documented on OCT by Day 30 postinjection compared with 4 of 13 patients (30.76%) without outer retina changes post-IVO. Normalization of the outer retina reflectivity was achieved in all cases.
  
  
  CONCLUSIONS
  In this case series of VMT/MH patients treated with ocriplasmin, changes in the SD-OCT outer retina reflectivity were relatively common. Within weeks, the outer retinal reflectivity on SD-OCT improved, as did the visual acuity. Further studies to investigate the association between outer retina reflectivity changes with the use of IVO and long-term visual acuity outcomes are warranted.
authors.affiliation: California Retina Consultants and Research Foundation, Santa Barbara, California.
authors.forename: Carlos
authors.initials: C
authors.lastname: Quezada-Ruiz
authors.forename: Dante J
authors.initials: DJ
authors.lastname: Pieramici
authors.forename: Maʼan
authors.initials: M
authors.lastname: Nasir
authors.forename: Melvin
authors.initials: M
authors.lastname: Rabena
authors.forename: Nathan
authors.initials: N
authors.lastname: Steinle
authors.forename: Alessandro A
authors.initials: AA
authors.lastname: Castellarin
authors.forename: Dilsher
authors.initials: D
authors.lastname: Dhoot
authors.forename: Stephen
authors.initials: S
authors.lastname: Couvillion
authors.forename: Robert F
authors.initials: RF
authors.lastname: See
authors.forename: Robert L
authors.initials: RL
authors.lastname: Avery
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005128:Eye Diseases / Q000188:drug therapy*; 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*; D012164:Retinal Diseases / Q000188:drug therapy*; D012165:Retinal Ganglion Cells / Q000473:pathology*; D012167:Retinal Perforations / Q000188:drug therapy*; D055213:Retinal Pigment Epithelium / Q000473:pathology; D012189:Retrospective Studies; D000267:Tissue Adhesions / Q000188:drug therapy; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy; D014822:Vitreous Body / Q000187:drug effects*
chemical_list: D005343:Fibrinolytic Agents; D010446:Peptide Fragments; C054561:microplasmin; D005341:Fibrinolysin