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• W2387059903 abstract "Symptomatic vitreomacular adhesion (VMA) is a rare condition caused by an incomplete posterior vitreous detachment of the vitreous body from the macula. Clinical signs of VMA include decrease of visual acuity (VA) or vision loss if untreated, metamorphopsia or central visual field defects. Posterior vitreous detachment (PVD) is a common phenomenon frequently related with ageing of ocular structures (Johnson 2010). In recent years, particular interest of researchers has been focused on the issue of pharmacologic agents to modify the molecular structure of the vitreous, a technique termed pharmacologic vitreolysis (Sebag 1998). In January 2013, ocriplasmin (Jetrea; ThromboGenic, Iselin, NY, USA) was approved by The European Commission of the European Union for the treatment of patients with symptomatic vitreomacular traction (VMT) with or without full-thickness macular hole (FTMH). Ocriplasmin is a protease subunit derived from human plasmin that hydrolyses collagen, laminin and fibronectin in the vitreous body and at the vitreoretinal interface (Kuppermann 2012). The aim of this retrospective analysis was to evaluate the structural and visual outcome in patients treated with ocriplasmin because of symptomatic VMT syndrome. Study included 16 patients treated in University Center of Ophthalmology and Oncology, Independent Public Clinical Hospital, Medical University of Silesia in Katowice (the average age was 75.6 ± 6.04). Twelve patients were diagnosed with VMT, the remaining 4 – VMT with macular hole. The study included 10 phakic and six pseudophakic (posterior chamber intra-ocular lens) patients. Before intravitreal treatment, patients underwent ophthalmologic examinations including best-corrected visual acuity (BCVA) using the Snellen visual acuity chart, slit lamp ophthalmoscopy, optical coherence tomography (OCT; Cirrus HD-OCT 500, Carl Zeiss Meditec AG, Jena, Germany) and intra-ocular pressure recording with a Goldmann applanation tonometer. For intravitreal therapy, 125 μg of ocriplasmin was administered via the pars plana at 3–4 mm posterior to the limbus. The injection was performed with a sterile technique using local anaesthesia. Control tests were conducted 1 day, 1 week and 1 month after the treatment. The primary outcome of VMT resolution was achieved in 12 patients (75%): eight phakic patients and four pseudophakic patients. Figure 1 presents A: OCT scan before treatment; B: 7 days after the injection; C: 28 days after the injection. We have observed that non-surgical VMT release occurred in two of four patients with macular hole. In two remaining patients, vitreomacular traction still pulled on the macula. After ocriplasmin injection, one patient developed large full-thickness macular hole, with hole size >400 μm according to Duker et al. (2013) classification. However, the development of macular hole did not prevent the release of VMT. Secondary outcome measures were visual acuity improvement and the incidence of ocular adverse events. We have found the increase of BCVA in 13 patients (81.25%) and no change in baseline vision in three patients (18.75%). The average pretreatment BCVA in the studied group was 0.39 ± 0.15. The mean BCVA at 28 day after the injection was 0.64 ± 0.15. During our study, there was no frequent self-reported ocular event following ocriplasmin injection. Patient-reported adverse events included eye pain and redness (one patient) as well as blurry vision and vitreous floaters (four patients). Most symptoms resolved by 1 week. This study demonstrates that intravitreal injection of ocriplasmin represents an effective treatment option in the management of patients with symptomatic vitreomacular disorders. It is confirmed by positive functional response to the treatment (BCVA improvement in 81.25% of patients) and by positive morphological response – VMT release in 75% of patients. Also, Varma et al. (2015) indicated clinically significant improvement in visual acuity in symptomatic VMT. Our study has reported that ocriplasmin is safe method resulting in minimal number of side-effects. Ocriplasmin, when injected intravitreally, induces vitreous liquefaction and separation of vitreoretinal adhesions at the macula and peripapillary retina." @default.
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• W2387059903 date "2016-05-11" @default.
• W2387059903 modified "2023-09-23" @default.
• W2387059903 title "Novel possibility of vitreomacular traction treatment" @default.
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• W2387059903 doi "https://doi.org/10.1111/aos.13075" @default.
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