Correlation of transient vision loss with outer retinal disruption following intravitreal ocriplasmin

Freund, K. Bailey; Shah, Sonal; Shah, Vaishali

doi:10.1038/eye.2013.94

Cited by 70 publications

(44 citation statements)

References 2 publications

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“…These symptoms are consistent with the pharmacodynamics of ocriplasmin that point to the majority of the efficacy occurring within 7 days of injection [32]. Ocriplasmin has been reported to cause disruption of photoreceptor layer possibly by reacting with the laminin at the interphotoreceptor matrix (IPM) [23,33,34] and microplasmin has also been shown to degrade laminin at the level of the photoreceptor layer in rat retina [10]. These findings seem to be in line with the loss of integrity of the ellipsoid zone and neurosensorial detachment (the IPM plays an important role in the adhesion of the retina to the retinal pigment epithelium [35]) with fluid accumulation observed in our study and other series [17,23,25,26,28].…”

Section: Discussionsupporting

confidence: 55%

The Portuguese Experience with Ocriplasmin in Clinical Practice

Figueira

Martins²,

Pessoa³

et al. 2016

Ophthalmic Res

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Aim: Evaluate the real-life experience with ocriplasmin on vitreomacular traction (VMT) release and full-thickness macular hole (FTMH) closure in Portugal. Methods: Multicentric, retrospective study of 83 eyes of 78 patients who were treated with intravitreal ocriplasmin for VMT with and without FTMH. Primary outcomes were VMT release and FTMH closure. Secondary outcomes included visual acuity changes and structural features on spectral-domain ocular coherence tomography. Results: VMT resolved in 47 of the 83 eyes (56.6%) and 6 of the 12 FTMH were closed (50.0%). Mean best-corrected visual acuity (BCVA) improved from 65.1 at baseline to 70.8 ETDRS letters at the end of follow-up (p < 0.0001) with a mean follow-up of 138.8 days. Improvement in BCVA was significantly better in eyes with VMT release (p = 0.021). Approximately 73% of patients had normal ellipsoid zone integrity at the end of follow-up, 87% had no neurosensorial detachment and 40% had no intra- or subretinal fluid. Conclusion: VMT release and FTMH closure were achieved in more than half of the treated eyes and were correlated with significant BCVA improvements and favorable baseline characteristics. In fact, if a careful patient selection is carried out, VMT resolution with ocriplasmin can be optimized, tailoring the best approach to each patient.

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Section: Discussionsupporting

confidence: 55%

The Portuguese Experience with Ocriplasmin in Clinical Practice

Figueira

Martins²,

Pessoa³

et al. 2016

Ophthalmic Res

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“…Seven patients showed resolution, while 4 patients demonstrated persistently depressed ERG responses. Freund and coauthors 5 recently described a patient with disruption of the ellipsoid layer after ocriplasmin injection. Possible mechanisms of retinal injury from ocriplasmin injection include mechanical effects from a transient increase in vitreomacular traction, enzymatic activity of ocriplasmin on the retinal extracellular matrix, and other toxic effects not specific to the proteinase activity of ocriplasmin.…”

Section: Discussionmentioning

confidence: 97%

Acute Panretinal Structural and Functional Abnormalities After Intravitreous Ocriplasmin Injection

2014

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the US Food and Drug Administration 1 approved ocriplasmin for the treatment of symptomatic vitreomacular adhesion. Ocriplasmin is a recombinant truncated form of plasmin with proteolytic activity against fibronectin and laminin, components of the vitreous gel. 2 The combined results of 2 phase 3 randomized clinical trials demonstrated that a single intravitreous injection of ocriplasmin resulted in resolution of vitreomacular adhesion in 26.5% of patients vs 10.1% of control subjects injected with placebo. 3 Reported adverse events included transient visual disturbances such as floaters, photopsias, and visual impairment. Herein, we report that such visual disturbances may be accompanied by substantial panretinal functional and structural abnormalities and propose a mechanism for this toxic reaction.

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“…Freund et al [14] confirmed that the proteolytic effect of ocriplasmin may induce rupturing of the outer segments of the photoreceptors. Indeed, determining whether ocriplasmin reaches the photoreceptors through the macular hole or transretinally could help predict which eyes are more at risk of this complication.…”

Section: Discussionmentioning

confidence: 75%

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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Correlation of transient vision loss with outer retinal disruption following intravitreal ocriplasmin

Cited by 70 publications

References 2 publications

The Portuguese Experience with Ocriplasmin in Clinical Practice

The Portuguese Experience with Ocriplasmin in Clinical Practice

Acute Panretinal Structural and Functional Abnormalities After Intravitreous Ocriplasmin Injection

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

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