title: EFFICACY AND SAFETY OF TREATMENT OPTIONS FOR VITREOMACULAR TRACTION: A Case Series and Meta-Analysis.
abstract: OBJECTIVE
  To evaluate treatment options for vitreomacular traction (VMT).
  
  
  METHODS
  A retrospective, consecutive case series and a literature search with Boolean search logic. A random-effects meta-analysis was conducted to combine the rates of VMT resolution per treatment. Patients from studies analyzed were placed into cohorts based on the treatment received.
  
  
  RESULTS
  
  
  
  METHODS
  Zero of 10 control, 3 of 7 intravitreal ocriplasmin (IVO, P = 0.10), 7 of 8 intravitreal expansile gas (pneumatic vitreolysis, PV, P < 0.01), and 10 of 10 pars plana vitrectomy (P < 0.01)-treated eyes experienced VMT release (VMTr) at Day 28. No patients developed retinal tears or detachment. One PV-treated (12.5%) eye developed a macular hole. Meta-analysis: Twenty-three of 131 prospective or retrospective and consecutive articles were included. Sixty-three eyes were treated with PV, 726 eyes were treated with intravitreal ocriplasmin, and 253 eyes were characterized as the control group (saline injection). The weighted rate of VMT resolution for the control group was 0.09 (95% confidence interval [CI]: 0.06-0.13), PV was 0.84 (95% CI: 0.76-0.92), and intravitreal ocriplasmin was 0.26 (95% CI: 0.23-0.29).
  
  
  CONCLUSIONS
  Our analysis found that PV releases VMT in most patients and suggest that PV may be as effective or superior to nonsurgical options for VMTr at Day 28 with a similar risk profile.
authors.affiliation: *Division of Ophthalmology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts; †Division of Ophthalmology, University of California, San Diego School of Medicine, La Jolla, California; ‡Division of Ophthalmology, Lille University School of Medicine, Lille, France; and §Boston University School of Medicine, Boston, Massachusetts.
authors.forename: Gina
authors.initials: G
authors.lastname: Yu
authors.forename: James
authors.initials: J
authors.lastname: Duguay
authors.forename: Kyle V
authors.initials: KV
authors.lastname: Marra
authors.forename: Shiva
authors.initials: S
authors.lastname: Gautam
authors.forename: Guillaume
authors.initials: G
authors.lastname: Le Guern
authors.forename: Shimul
authors.initials: S
authors.lastname: Begum
authors.forename: Arya
authors.initials: A
authors.lastname: Sharifzadeh
authors.forename: Jorge G
authors.initials: JG
authors.lastname: Arroyo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D058450:Endotamponade; D005260:Female; D005341:Fibrinolysin / Q000627:therapeutic use; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D005466:Fluorocarbons / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D010446:Peptide Fragments / Q000627:therapeutic use; D012164:Retinal Diseases / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D012189:Retrospective Studies; D000267:Tissue Adhesions / Q000628:therapy; D016896:Treatment Outcome; D014821:Vitrectomy / Q000379:methods*; D014822:Vitreous Body / Q000473:pathology; D020255:Vitreous Detachment / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*
chemical_list: D005343:Fibrinolytic Agents; D005466:Fluorocarbons; D010446:Peptide Fragments; C054561:microplasmin; C042852:perflutren; D005341:Fibrinolysin