Ocriplasmin use in a selected case with preserved visual acuity.
BACKGROUND
Previous studies described cases of Ocriplasmin injections in patients with vitreo-macular traction and reduced central visual acuity. We describe the first case of a patient with 20/20 visual acuity and vitreo-macular traction treated with Ocriplasmin, and, for the first time in literature, we evaluated the functional changes of the macula in response to pharmacological treatment through multifocal-electroretinogram.


METHODS
We report the case of a female Caucasian patient aged 67 years with vitreo-macular traction in the right eye, treated with Ocriplasmin, at the Eye Clinic of the Second University of Naples. Visual acuity was 20/20 before treatment, associated with metamorphopsia. Two weeks after injection, optical coherence tomography showed the release of vitreo-macular traction and multifocal electroretinogram responses showed a significant increase of retinal density responses in all six rings (p < 0.03). Visual acuity remained constant with resolution of symptoms and the appearance of vitreous floaters.


CONCLUSIONS
Intravitreal injection of Ocriplasmin resulted to be a safe and effective treatment in the case here reported. Our data show that the anatomical recovery with release of vitreo-macular traction was associated with a full functional recovery. In fact, the electrical retinal density response of the macular area improved two weeks after Ocriplasmin injection. Further studies with broader inclusion criteria for Ocriplasmin treatment (e.g. also with visual acuity higher than 20/25) on a larger study sample are needed to confirm our results.
Multidisciplinary Department of Medical, Surgical and Dental Sciences, Eye Clinic, Second University of Naples, Via Sergio Pansini, 5, 80131, Naples, Italy. settimio.rossi@unina2.it.
Settimio
S
Rossi
Multidisciplinary Department of Medical, Surgical and Dental Sciences, Eye Clinic, Second University of Naples, Via Sergio Pansini, 5, 80131, Naples, Italy. ada_orrico@hotmail.it.
Ada
A
Orrico
Multidisciplinary Department of Medical, Surgical and Dental Sciences, Eye Clinic, Second University of Naples, Via Sergio Pansini, 5, 80131, Naples, Italy. paolo.melillo@unina2.it.
Paolo
P
Melillo
Multidisciplinary Department of Medical, Surgical and Dental Sciences, Eye Clinic, Second University of Naples, Via Sergio Pansini, 5, 80131, Naples, Italy. francesco.testa@unina2.it.
Francesco
F
Testa
Multidisciplinary Department of Medical, Surgical and Dental Sciences, Eye Clinic, Second University of Naples, Via Sergio Pansini, 5, 80131, Naples, Italy. francesca.simonelli@unina2.it.
Francesca
F
Simonelli
Multidisciplinary Department of Medical, Surgical and Dental Sciences, Eye Clinic, Second University of Naples, Via Sergio Pansini, 5, 80131, Naples, Italy. michele.dellacorte@unina2.it.
Michele
M
Della Corte
D000368:Aged; D004596:Electroretinography; D005260:Female; D005341:Fibrinolysin / Q000627:therapeutic use*; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D058449:Intravitreal Injections; D010446:Peptide Fragments / Q000627:therapeutic use*; D012160:Retina / Q000502:physiology; D012164:Retinal Diseases / Q000188:drug therapy* / Q000503:physiopathology; D000267:Tissue Adhesions / Q000188:drug therapy; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology*; D014822:Vitreous Body / Q000187:drug effects*
D005343:Fibrinolytic Agents; D010446:Peptide Fragments; C054561:microplasmin; D005341:Fibrinolysin