Rhegmatogenous retinal detachment following intravitreal ocriplasmin.
OBJECTIVE
To describe the characteristics and outcomes of patients presenting with rhegmatogenous retinal detachment (RRD) after ocriplasmin (OCP) injection.


METHODS
Retrospective, multi-centre, observational case series with case note review.


RESULTS
Eight patients with symptomatic vitreomacular traction (six with concomitant macular hole) were diagnosed with RRD after a median of 16 days (range 3-131 days) post-OCP injection. Presentation was within 3 weeks of the OCP injection in six of the cases. Five patients presented with symptoms post-OCP, and three were diagnosed asymptomatically on planned visits. Seven cases were phakic, one had high myopia (>8 dioptres), and two cases had lattice degeneration. Following RRD surgery, hole closure was achieved in 5/6 MH cases. The final median BCVA at 7 months was 20/80 (range 20/40-20/1200) similar to the baseline BCVA 20/80, with four patients gaining ≥1 line of vision compared to baseline but three losing ≥3 lines.


CONCLUSIONS
RRD is a non-negligible risk associated with intravitreal OCP, and it should be used with caution in eyes with high myopia and peripheral retinal pathology predisposing to RRD. Detailed peripheral retinal examination is recommended pre- and postoperatively at all visits. Patients should be advised to seek attention if symptoms recur after initial presentation.
Sunderland Eye Infirmary, Queen Alexandra Road, Sunderland, SR2 9HP, UK.
Haifa A
HA
Madi
Bristol Eye Hospital, Lower Maudlin Street, Bristol, UK.
Richard J
RJ
Haynes
Ophthalmology Department, Cumberland Infirmary, Carlisle, UK.
Diana
D
Depla
Eye Department, Rigshospitalet, Glostrup, Ndr. Ringvej 57, 2600, Glostrup, Denmark.
Morten D
MD
de la Cour
Department of Ophthalmology, Academic Medical Centre, Meibergdreef 9, 1100 DD, Amsterdam, The Netherlands.
Sarit
S
Lesnik-Oberstein
Vitreoretinal Service, Moorfields Eye Hospital, City Road, London, UK.
Mahi M K
MM
Muqit
Manchester Royal Eye Hospital, Oxford Road, Manchester, UK.
Niall
N
Patton
Royal Wolverhampton NHS Trust, Wolverhampton & Midland Counties Eye Infirmary, Wolverhampton, UK.
Nick
N
Price
Sunderland Eye Infirmary, Queen Alexandra Road, Sunderland, SR2 9HP, UK. David.steel@ncl.ac.uk.|Institute of Genetic Medicine, Newcastle University, Newcastle Upon Tyne, UK. David.steel@ncl.ac.uk.
David H W
DH
Steel
D000368:Aged; D005260:Female; D005341:Fibrinolysin / Q000008:administration & dosage / Q000009:adverse effects*; D005500:Follow-Up Studies; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D008875:Middle Aged; D010446:Peptide Fragments / Q000008:administration & dosage / Q000009:adverse effects*; D011379:Prognosis; D012160:Retina / Q000187:drug effects / Q000473:pathology*; D012163:Retinal Detachment / Q000139:chemically induced* / Q000175:diagnosis; D012167:Retinal Perforations / Q000175:diagnosis / Q000188:drug therapy; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence / Q000379:methods; D014792:Visual Acuity; D020255:Vitreous Detachment / Q000175:diagnosis / Q000188:drug therapy
D010446:Peptide Fragments; C054561:microplasmin; D005341:Fibrinolysin
Macular hole; Ocriplasmin; Pharmacological vitreolysis; Retinal detachment; Retinal tears; Vitreomacular traction