Treatment of Vitreomacular Traction With Intravitreal Perfluoropropane (C3f8) Injection

Steinle, Nathan; Dhoot, Dilsher S.; Ruiz, Carlos Quezada; Castellarin, Alessandro; Pieramici, Dante J.; See, Robert F.; Couvillion, Steven C; Nasir, Maʼan; Avery, Robert L.

doi:10.1097/iae.0000000000001237

Cited by 38 publications

(55 citation statements)

References 41 publications

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“…We excluded eyes with only inner retinal changes or minor outer retinal abnormality because such subtle changes may be subject to individual judgement, and these cases tend to be stable over time and may go through spontaneous resolution [21] . Our results were compatible with other studies as summarized in Table 3 [1][2][3][4][5][6][7][8] . Rodrigues et al [2] analyzed the pretreatment SD-OCT features associated with a higher VMT resolution rate, and found that eyes with a lower horizontal length of vitreomacular adhesion, lower maximum foveal thickness (<500 μm), and lower vitreous face reflectivity had higher success rates.…”

Section: Discussionsupporting

confidence: 93%

Vitreomacular Changes after Intravitreal Gas Injection for Idiopathic Impending or Early Macular Hole: An Optical Coherence Tomography Study

et al. 2017

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Purpose: To study the early changes of vitreomacular microstructure by optical coherence tomography (OCT) after intravitreal gas injection for the treatment of idiopathic impending or early full-thickness macular hole (FTMH). Methods: A retrospective, interventional case series. Results: A total of 21 eyes were included. In the impending macular hole, 8/8 achieved vitreomacular traction (VMT) release, while a macular hole developed in 1 case. On postoperative day 1, the vitreomacular configuration by OCT showed either a flattening (n = 3) or elevation (n = 1) pattern. In early FTMH, vitreomacular separation was achieved in 10/13 cases, but macular hole closure was only observed in 3 cases. On postoperative day 1, only flattening of the vitreomacular configuration was observed (n = 5). Enlargement of the macular hole was found in 4 cases. Conclusions: VMT separation can be achieved with intravitreal gas injection by mechanically stretching the posterior vitreous cortex, causing either flattening or steepening of the vitreomacular configuration. However, it did not always result in macular hole closure.

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Section: Discussionsupporting

confidence: 93%

Vitreomacular Changes after Intravitreal Gas Injection for Idiopathic Impending or Early Macular Hole: An Optical Coherence Tomography Study

et al. 2017

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“…Three studies, conducted by Rodrigues et al, Steinle et al, and Chan et al, investigating the release rate of VMT and MH closure using intravitreal perfluoropropane (C3F8) gas showed very promising results [4][5][6]. The purpose of the present case series was to further examine the effect of a single intravitreal C3F8 gas injection with patients showing symptomatic VMT with or without MH.…”

Section: Introductionmentioning

confidence: 87%

Effect of intravitreal C3F8 gas in patients with vitreomacular traction

Haas

Mayer

Wackernagel

2017

Spektrum Augenheilkd.

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SummaryBackground We aimed to assess the efficacy of a single intravitreal perfluoropropane (C3F8) gas injection for the treatment of vitreomacular traction with or without a macular hole. Methods In this retrospective case series, seven eyes of six patients with symptomatic vitreomacular traction documented on optical coherence tomography, one with a macular hole additionally, received a single intravitreal C3F8 gas injection of up to 0.3 ml. The primary endpoint was vitreomacular traction release at 1 month after injection. Secondary endpoints included resolution of vitreomacular adhesion within 6 months, nonsurgical closure of macular holes, and change in central foveal thickness and best-corrected visual acuity. Results Overall, on optical coherence tomography, six of seven eyes (85.7%) had release of vitreomacular traction during the entire study duration: three within 1 month of injection and the other three within 6 months. Of the latter group, two of the three eyes showed a concurrent epiretinal membrane and one concurrent diabetic retino-and maculopathy. The patient with a macular hole had resolution of vitreomacular traction within 1 month but had to undergo vitrectomy because of nonclosure of the macular hole. Associated adverse events were macular edema with a consequent lamellar hole after injection in one patient, and another patient developed retinal detachment. Conclusion Intravitreal C3F8gas injection is an inexpensive and promising minimally invasive option for the treatment of symptomatic and persistent vitreo-

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“…When patients were being enrolled in our study, reports on the alternative use of gas injection to release vitreomacular traction were limited to a few publications, and the very good results such as those published recently [16] could further decrease the role of ocriplasmin in this pathology. This technique seems to be more effective than ocriplasmin injection as a primary treatment for vitreomacular traction, but its use for small macular holes with traction is not yet fully established [17] and a few contraindications to gas injection (mainly air travel and late-stage glaucoma) remain.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Results of Vitrectomy for Macular Holes after Failure of Vitreolysis

Benarous¹,

Y²

2018

Ophthalmologica

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Purpose: Ocriplasmin injection may close some small-to-medium macular holes associated with vitreoretinal traction. If the treatment fails, does vitrectomy and gas injection yield the same results as primary surgery? Material and Methods: We report a retrospective case series study of 3 eyes of 3 consecutive patients operated on a few months after initial intravitreal injection of ocriplasmin and enlargement of the macular hole. The minimal follow-up period after surgery was 18 months. Results: Surgery was uneventful in all cases. Vitrectomy, internal limiting membrane peeling, and gas injection allowed closing of the 3 macular holes with a progressive improvement in visual acuity over time. Before ocriplasmin injection, visual acuity ranged from 20/60 to 20/32, after failed ocriplasmin injection from 20/80 to 20/40, and at the final follow-up after 18 months from 20/32 to 20/25. Conclusion: Vitrectomy with internal limiting membrane peeling leads to closure of macular holes even in cases of prior failure to close them by ocriplasmin injection.

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Treatment of Vitreomacular Traction With Intravitreal Perfluoropropane (C3f8) Injection

Abstract: Office-based intravitreal injection of C3F8 offers an inexpensive and effective treatment for vitreomacular traction, including for patients who underwent previous ocriplasmin administration and in patients with diabetes mellitus or epiretinal membrane.

Cited by 38 publications

References 41 publications

Vitreomacular Changes after Intravitreal Gas Injection for Idiopathic Impending or Early Macular Hole: An Optical Coherence Tomography Study

Vitreomacular Changes after Intravitreal Gas Injection for Idiopathic Impending or Early Macular Hole: An Optical Coherence Tomography Study

Effect of intravitreal C3F8 gas in patients with vitreomacular traction

Long-Term Results of Vitrectomy for Macular Holes after Failure of Vitreolysis

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