title: RESOLUTION OF SUBRETINAL FLUID AND OUTER RETINAL CHANGES IN PATIENTS TREATED WITH OCRIPLASMIN.
abstract: OBJECTIVE
  To evaluate the aftermarket efficacy of ocriplasmin for vitreomacular adhesion (VMA) and identify the frequency and duration of structural changes on optical coherence tomography.
  
  
  METHODS
  The authors conducted a retrospective case series of 36 eyes treated with ocriplasmin for symptomatic VMA at a single center between February 2013 and September 2013. Eyes were evaluated for release of VMA at 1 month postinjection, preinjection adhesion size, postinjection closure of macular hole, presence of subretinal fluid after release of adhesion, size of subretinal fluid, outer retinal structural change, and visual acuity at 1 month, 6 months, and 1 year.
  
  
  RESULTS
  Fifteen eyes (42%) had complete release of VMA at 1 month postinjection, and 78% of eyes had closure of the macular hole. Eyes that did not have an epiretinal membrane that had a smaller initial adhesion size and a smaller macular hole size were more likely to have complete release of VMA. Subretinal fluid was present after release in 73.3% of treated eyes, and ellipsoid zone changes were present in 66.7% of treated eyes. At the end of 1 year, complete resolution of subretinal fluid occurred in 87% of treated eyes with only trace subretinal fluid remaining in 2 eyes. Complete resolution of ellipsoid zone changes was found in all eyes. Best-corrected visual acuity improved throughout the first year after treatment.
  
  
  CONCLUSIONS
  Ocriplasmin is effective in the treatment of patients with symptomatic VMA. Results can be improved with patient selection based on specific criteria. Subretinal fluid and ellipsoid zone changes are common after treatment but mostly resolve over 1 year.
authors.affiliation: *Department of Ophthalmology, Shiley Eye Center, University of California, San Diego, California; †Department of Psychological and Brain Sciences, University of California, Santa Barbara, California; ‡Associated Retinal Consultants, Royal Oak, Michigan; and §Beaumont Eye Institute, Oakland University William Beaumont School of Medicine.
authors.forename: Eric
authors.initials: E
authors.lastname: Nudleman
authors.forename: Michael S
authors.initials: MS
authors.lastname: Franklin
authors.forename: Jeremy D
authors.initials: JD
authors.lastname: Wolfe
authors.forename: George A
authors.initials: GA
authors.lastname: Williams
authors.forename: Alan J
authors.initials: AJ
authors.lastname: Ruby
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; 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* / Q000378:metabolism; D012189:Retrospective Studies; D058471:Subretinal Fluid / Q000378:metabolism*; D000267:Tissue Adhesions / Q000188:drug therapy / Q000378:metabolism; D041623:Tomography, Optical Coherence; D014792:Visual Acuity; D014821:Vitrectomy; D020255:Vitreous Detachment / Q000188:drug therapy* / Q000378:metabolism
chemical_list: D005343:Fibrinolytic Agents; D010446:Peptide Fragments; C054561:microplasmin; D005341:Fibrinolysin