To compare the functional and morphologic outcome of patients with vitreomacular traction (VMT) treated with either ocriplasmin treatment or vitrectomy.
Retrospective case series of patients treated with ocriplasmin or vitrectomy for VMT. Outcome measures: resolution of VMT, change in outer retinal thickness, integrity of ellipsoid zone, subretinal fluid formation, and best-corrected visual acuity 2 weeks and 4 months after treatment.
Fourteen eyes received ocriplasmin (Group 1). Vitreomacular traction resolved in 50% (Group 1a), and in 50%, it did not (Group 1b). Ten eyes underwent vitrectomy (Group 2). Vitreomacular traction resolved in 100%. Outer retinal thickness decreased significantly 2 weeks after treatment in Group 1 (P = 0.003) and in 1a (P = 0.018). Two weeks after treatment, Group 1a showed a disruption of the ellipsoid zone (P = 0.001) and subretinal fluid formation (P = 0.01) more often than 1b. Neither was observed 4 months after treatment. Best-corrected visual acuity decreased significantly in Groups 1 (P = 0.034) and 1a (P = 0.026).
Most patients treated with ocriplasmin for VMT showed a transient reduction of best-corrected visual acuity, accumulation of subretinal fluid, and a loss of the ellipsoid zone after the resolution of VMT. Patients with surgical resolution of VMT did not show these findings. The advantage of a less-invasive intravitreal injection of ocriplasmin must be weighed against the lower success rate, the (transient) morphologic changes, and the uncertain visual benefit.
Ocriplasmin is a drug for the treatment of patients with vitreomacular traction. Compared with the surgical resolution of vitreomacular traction, the resolution rate is lower and, unlike vitrectomy, ocriplasmin leads to transient vision loss, a disruption of the ellipsoid zone, and subretinal fluid formation.
*Department of Ophthalmology, University Hospital of Cologne, Cologne, Germany;
†Department of Ophthalmology, City Hospital Triemli, Zurich, Switzerland;
‡University of Zurich, Zurich, Switzerland; and
§F. Hoffmann-La Roche, Basel, Switzerland.
Reprint requests: Paula Scholz, MD, FEBO, Department of Ophthalmology, University Hospital of Cologne, Kerpener Strasse 62, 50937 Cologne, Germany; e-mail: firstname.lastname@example.org
None of the authors has any financial/conflicting interests to disclose.