Comparison of the horizontal diameter to a modeled area of traction in eyes with vitreomacular traction: is the diameter close enough to the truth?

Paul, Christoph C.; Krug, P.; Müller, Hans‐Helge; Wachtlin, Joachim; Mennel, Stefan; Müller, S. C.; Schmitz-Valckenberg, Steffen; Bertelmann, Thomas; Schumann, Ricarda G.

doi:10.1007/s00417-018-4055-0

Cited by 4 publications

(3 citation statements)

References 20 publications

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“…The OCT imaging protocol used meant that we were unable to use en face viewing to measure the area of VMT attachment and report horizontal width of attachment only. It is known that vitreous attachment can be non‐circular, and therefore, area of traction is likely to give a more complete assessment than width alone (Paul, et al 2018). A further limitation of the OCT imaging acquisition was that different machines were used in the two centres, which may have affected the accuracy of the results.…”

Section: Discussionmentioning

confidence: 99%

Determinants of vitreomacular traction width: associations with foveal floor width and vitreoretinal interface changes

Grinton

Melville

George

et al. 2020

Acta Ophthalmologica

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To investigate the relationship between vitreomacular traction (VMT) width, foveal floor width (FFW) and other anatomical characteristics between eyes of patients with VMT. Retrospective observational study of unilateral and bilateral VMT cases from two specialist ophthalmic centres in the United Kingdom (UK) between 2016 and 2018. For unilateral VMT cases: VMT width in the affected eye and FFW in the non‐affected fellow eye were measured. In bilateral VMT cases: VMT width in both eyes was measured. In all cases, the presence of any associated inner or outer retinal, and vitreoretinal interface (VRI) changes, including epiretinal membrane, was also documented. 88 patients fulfilled the study criteria: 57 having unilateral and 31 bilateral VMT. For unilateral VMT cases, log (VMT) width was significantly correlated with FFW (r = 0.347, p = 0.008). Using stepwise linear regression, FFW (p = 0.004) and VRI changes (p = 0.03) were both significantly associated with VMT width with a R2 of 0.21. In bilateral VMT cases, there was strong positive correlation between log (VMT) width (r = 0.88, p < 0.001), and the presence of any VRI (r = 0.90, p < 0.001) or outer retinal changes (r = 0.50, p < 0.001) between the two eyes. These findings suggest that individual variations in foveal morphology as measured by the FFW, along with the presence of vitreoretinal interface changes, are associated with the extent of VMT width. VMT width, VRI and outer retinal changes were also highly correlated between eyes in bilateral VMT, suggesting that individual patient factors, which may be genetic or acquired, determine their presence and extent.

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Section: Discussionmentioning

confidence: 99%

Determinants of vitreomacular traction width: associations with foveal floor width and vitreoretinal interface changes

Grinton

Melville

George

et al. 2020

Acta Ophthalmologica

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“…This suggests that patients treated with ocri-plasmin vs control might still benefit from partial release of traction, so the surrogate endpoint defined as a binary response was unable to capture the functional improvement after treatment. The area of traction is important for therapeutic recommendation; hence the need for a more precise description of the area of traction in eyes with VMT 40. The patient’s perspective does matter in the quantification of functional benefit.…”

Section: Discussionmentioning

confidence: 99%

<p>Patient-reported outcomes of ocriplasmin for the treatment of vitreomacular traction: a systematic review and synthesis of the literature</p>

Lescrauwaet¹,

Blot²,

Jackson³

2019

PROM

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Purpose Vitreomacular traction (VMT) is a disease in which the vitreous exerts abnormally strong traction on the macula, the area of the eye responsible for detailed central vision. If this traction significantly distorts the macula then VMT can lead to troublesome distorted vision (metamorphopsia), sometimes occurring despite relatively preserved visual acuity. Ocriplasmin, administered as a single intravitreal injection, aims to release VMT and improve vision. While the effect of ocriplasmin on traction release and visual acuity is well characterized, the effect of symptoms like metamorphopsia is not. Methods A systematic review and synthesis of the literature on patient reported outcomes (PRO) in relation to the use of ocriplasmin for the treatment of VMT was undertaken using MED-LINE and Embase databases, and the Cochrane central register of controlled trials (CENTRAL). Results The review identified PRO data from 870 patients across three randomized controlled trials. The most commonly reported PROs were the 25-item National Eye Institute Visual Function Questionnaire (VFQ-25), a broad measure of vision-related quality of life, and Visual Function Response (VFR), an outcome combining quality of life and visual acuity outcomes. Treatment with ocriplasmin produced significant patient benefit vs control (sham or placebo-injection). Ocriplasmin was associated with a higher proportion of patients experiencing a clinically meaningful improvement in visual functioning with a difference of 11.8% for VFQ-25 and 23.2% for VFR responder analyses, respectively. Conclusion Patients with VMT have material impairment in visual functioning and quality of life, relative to their reduction in visual acuity. Ocriplasmin results in a significant improvement in visual functioning. Future research could include the development of new PROs specific to VMT.

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“…The most comprehensive data on this have been generated for IVO, for which randomized controlled trials have been performed, in contrast to intravitreal gas injection or observation. Younger age, female gender, smaller adhesion diameter (as a surrogate for adhesion area [ 11 ]), phakic lens status, and the absence of an ERM have been linked to a higher frequency of VMT resolution after IVO treatment. Of these factors, lens status is highly correlated to age and is possibly not an independent predictor [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Calculating the individual probability of successful ocriplasmin treatment in eyes with vitreomacular traction–Validation and refinement of a multivariable prediction model

Paul

Müller²,

Raber³

et al. 2022

PLoS ONE

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Purpose To evaluate a multivariable model predicting the individual probability of successful intravitreal ocriplasmin (IVO) treatment in eyes with vitreomacular traction (VMT). Methods Data from three prospective, multicenter IVO studies (OASIS, ORBIT, and INJECT) were pooled. Patients were included if they were treated for a symptomatic VMT without a full-thickness macular hole. A prediction model for VMT resolution using the factors ‘age’ and ‘horizontal VMT diameter’ was validated by receiver operating characteristic analysis and according to grouped prediction after calibration. Multivariable regression analysis was performed to check robustness and explore further improvements. Results Data from 591 eyes was included. In the univariate analysis all key factors (age, gender, VMT diameter, lens status, ERM) significantly correlated to treatment success. The prediction model was robust and clinically applicable to estimate the success rate of IVO treatment (AUC of ROC: 0.70). A refinement of the model was achieved through a calibration process. Conclusion The developed multivariable model using ‘horizontal VMT diameter’ and ‘age’ is a valid tool for prediction of VMT resolution upon IVO treatment.

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Comparison of the horizontal diameter to a modeled area of traction in eyes with vitreomacular traction: is the diameter close enough to the truth?

Cited by 4 publications

References 20 publications

Determinants of vitreomacular traction width: associations with foveal floor width and vitreoretinal interface changes

Determinants of vitreomacular traction width: associations with foveal floor width and vitreoretinal interface changes

<p>Patient-reported outcomes of ocriplasmin for the treatment of vitreomacular traction: a systematic review and synthesis of the literature</p>

Calculating the individual probability of successful ocriplasmin treatment in eyes with vitreomacular traction–Validation and refinement of a multivariable prediction model

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