title: INTRAVITREAL OCRIPLASMIN IN CLINICAL PRACTICE: Predictors of Success, Visual Outcomes, and Complications.
abstract: OBJECTIVE
  To investigate predictors of success, visual outcomes, and complications of intravitreal ocriplasmin for the treatment of symptomatic vitreomacular adhesion in a clinical care setting.
  
  
  METHODS
  Retrospective chart review of 49 consecutive eyes of 47 patients who received intravitreal ocriplasmin. Spectral domain optical coherence tomography scans were examined for vitreomacular traction (VMT) release, full-thickness macular hole (FTMH) closure, and other changes in retinal anatomy.
  
  
  RESULTS
  Pharmacologic VMT release occurred in 41% of eyes; positive predictors included age ≤75 years (P = 0.001), phakic status (P = 0.016), VMT width ≤750 μm (P = 0.001), and absence of retinal comorbidities (P = 0.035). Pharmacologic FTMH closure occurred in 25% of cases; positive predictors included successful VMT release (P = 0.042), better preinjection best-corrected visual acuity (P = 0.036), and smaller FTMH aperture width (P = 0.033). Eyes that achieved VMT release and did not undergo surgery attained significant improvement in best-corrected visual acuity (P = 0.015). Complications included subfoveal lucency (33%), ellipsoid zone disruption (33%), and FTMH base enlargement (75%). Only FTMH base enlargement resulted in worse visual outcomes (P = 0.024). Subgroup analysis of 14 eyes with ideal characteristics (all positive predictors listed above) yielded a 93% VMT release rate.
  
  
  CONCLUSIONS
  Proper case selection may facilitate successful pharmacologic vitreolysis with ocriplasmin, improve visual outcomes, and minimize potential complications.
authors.affiliation: Department of Ophthalmology, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey.
authors.forename: Henry L
authors.initials: HL
authors.lastname: Feng
authors.affiliation: Department of Ophthalmology, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey.
authors.forename: Daniel B
authors.initials: DB
authors.lastname: Roth
authors.affiliation: Department of Ophthalmology, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey.
authors.forename: Aisha
authors.initials: A
authors.lastname: Hasan
authors.affiliation: Department of Ophthalmology, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey.
authors.forename: Howard F
authors.initials: HF
authors.lastname: Fine
authors.affiliation: Department of Ophthalmology, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey.
authors.forename: H Matthew
authors.initials: HM
authors.lastname: Wheatley
authors.affiliation: Department of Ophthalmology, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey.
authors.forename: Jonathan L
authors.initials: JL
authors.lastname: Prenner
authors.affiliation: Department of Ophthalmology, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey.
authors.forename: Sumit P
authors.initials: SP
authors.lastname: Shah
authors.affiliation: Department of Ophthalmology, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey.
authors.forename: Kunjal K
authors.initials: KK
authors.lastname: Modi
authors.affiliation: Bascom Palmer Eye Institute, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida.
authors.forename: William J
authors.initials: WJ
authors.lastname: Feuer
mesh_terms: D000368:Aged; D005260:Female; D005341:Fibrinolysin / Q000008:administration & dosage*; D005500:Follow-Up Studies; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D010446:Peptide Fragments / Q000008:administration & dosage*; D012167:Retinal Perforations / Q000175:diagnosis / Q000188:drug therapy*; D012189:Retrospective Studies; D000267:Tissue Adhesions / Q000175:diagnosis / Q000188:drug therapy; D041623:Tomography, Optical Coherence / Q000379:methods*; D016896:Treatment Outcome; D014792:Visual Acuity; D020255:Vitreous Detachment / Q000175:diagnosis / Q000188:drug therapy*
chemical_list: D010446:Peptide Fragments; C054561:microplasmin; D005341:Fibrinolysin