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IMPACT OF VITREORETINAL INTERFACE ARCHITECTURE ON SUCCESSFUL VITREOMACULAR TRACTION RESOLUTION IN EYES SCHEDULED FOR INTRAVITREAL OCRIPLASMIN THERAPY

Paul, Christoph MD*; Heun, Christine MD*; Müller, Hans H. PhD; Fauser, Sascha MD; Kaymak, Hakan MD§; Kazerounian, Sara MD; Sekundo, Walter MD*; Mennel, Stefan MD**; Meyer, Carsten H. MD††; Schmitz-Valckenberg, Steffen MD‡‡; Koss, Michael J. MD§§; Feltgen, Nicolas MD¶¶; Bertelmann, Thomas MD¶¶

doi: 10.1097/IAE.0000000000001371
Original Study

Purpose: To evaluate the impact of the vitreoretinal interface architecture, in specific the angle between the posterior vitreous cortex and the internal limiting membrane, on vitreomacular traction (VMT) resolution in eyes treated with intravitreally injected ocriplasmin (Jetrea).

Methods: Retrospective, multicenter cohort study and exploratory data analysis. Spectral domain optical coherence tomography assessments were performed before scheduled ocriplasmin injections. General (age and sex) as well as ocular variables (lens status, presence of epiretinal membrane formations, horizontal diameter of VMT, central retinal thickness, and in particular various prespecified angles between the posterior vitreous cortex and internal limiting membrane) were analyzed to evaluate their impact on successful VMT resolution.

Results: Fifty-nine eyes of 59 patients were included. Univariate analysis of age (odds ratio [OR]: 0.881; 95% CI: [0.812–0.955]; P = 0.0022) and lens status (OR: 11.03; 95% CI: [2.23–54.57]; P = 0.0033) had a significant impact on successful VMT resolution, whereas sex (OR: 0.668; 95% CI: [0.126–2.065]; P = 0.4906), epiretinal membrane formation (OR: 0.581; 95% CI: [0.168–2.006]; P = 0.3903), horizontal diameter of VMT (OR: 0.99930; 95% CI: [0.99825–1.00035]; P = 0.1886), and central retinal thickness (OR: 0.9985; 95% CI: [0.9934–1.00436]; P = 0.56) failed. The angle at 500 μm apart from the fovea centralis, irrespective if measured nasally (OR: 1.135; 95% CI: [1.013–1.272]; P = 0.0289) or temporally (OR: 1.099; 95% CI: [1.001–1.208]; P = 0.0485), showed a significant correlation with VMT resolution.

Conclusion: The angle between the posterior vitreous cortex and the internal limiting membrane 500 μm apart from the fovea centralis correlates with VMT resolution and may be a clinically useful marker for selection of patients to be treated with ocriplasmin. This observation needs to be proven in a prospective confirmatory investigation.

The architecture of the vitreoretinal interface and, in specific, the angle between the posterior vitreous cortex and the internal limiting membrane 500 μm apart from the fovea centralis proved to have a significant impact on successful vitreomacular traction resolution after a single intravitreal ocriplasmin (Jetrea) injection.

*Department of Ophthalmology, Philipps-University Marburg, Germany;

Institute of Medical Biometry and Epidemiology, Philipps-University Marburg, Marburg, Germany;

Department of Ophthalmology, University of Cologne, Cologne, Germany;

§Internationale Innovative Ophthalmochirurgie (IIO), Düsseldorf, Germany;

Department of Ophthalmology, Knappschaftskrankenhaus Sulzbach, Sulzbach, Germany;

**Department of Ophthalmology, Feldkirch State Hospital, Feldkirch, Austria;

††Department of Ophthalmology, Pallas Clinic, Aarau, Switzerland;

‡‡Department of Ophthalmology, Rheinische Friedrich-Wilhelms-University, Bonn, Germany;

§§Department of Ophthalmology, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany; and

¶¶Department of Ophthalmology, University Medical Center Goettingen, Goettingen, Germany.

Reprint requests: Thomas Bertelmann, MD, Department of Ophthalmology, University Medical Center Goettingen, Robert-Koch-Str, Goettingen 4037075, Germany; e-mail: thomas.bertelmann@icloud.com

Paper presented at the EURETINA congress, Copenhagen, Denmark, September 8–11, 2016.

© 2017 by Ophthalmic Communications Society, Inc.