Macula Society Collaborative Retrospective Study of Ocriplasmin for Symptomatic Vitreomacular Adhesion

Jennifer I Lim; Adam R Glassman; Lloyd Paul Aiello; Usha Chakravarthy; Christina J Flaxel; Lawrence J Singerman; Richard F Spaide; Daniel B Roth; Macula Society Ocriplasmin for Vitreomacular Traction Study Group

doi:10.1016/j.oret.2016.10.018

Macula Society Collaborative Retrospective Study of Ocriplasmin for Symptomatic Vitreomacular Adhesion

Ophthalmol Retina. 2017 Sep-Oct;1(5):413-420. doi: 10.1016/j.oret.2016.10.018. Epub 2017 Apr 25.

Authors

Jennifer I Lim¹, Adam R Glassman², Lloyd Paul Aiello³, Usha Chakravarthy⁴, Christina J Flaxel⁵, Lawrence J Singerman⁶, Richard F Spaide⁷, Daniel B Roth⁸; Macula Society Ocriplasmin for Vitreomacular Traction Study Group

Collaborators

Macula Society Ocriplasmin for Vitreomacular Traction Study Group:
Lloyd P Aiello, Jorge G Arroyo, Sophie J Bakri, Charlie C Barr, Caroline R Baumal, Kevin J Blinder, Usha Chakravarthy, Nauman Chaudhry, Victor Chong, Albert O Edwards, Allan Hunter, Michael J Elman, Michel E Farah, Gary Fish, Christina J Flaxel, Alfonso Giovannini, Frank G Holz, Rahul N Khurana, Gregg T Kokame, Jennifer I Lim, H Richard McDonald, Stephan Michels, Roger L Gary Novack, Maurizio Battaglia Parodi, Carl D Regillo, Daniel B Roth, Lawrence J Singerman, Kent W Small, Fadi S Shaya, Rickard F Spaide, Giovani Staurenghi, Jennifer Sun, Demetrios Vavvas, Charles Wykoff, Lucy H Y Young

Affiliations

¹ University of Illinois at Chicago, Illinois Eye and Ear Infirmary, Chicago, Illinois. Electronic address: jennylim@uic.edu.
² The Jaeb Center for Health Research, Tampa, Florida.
³ Beetham Eye Institute, Joslin Diabetes Center, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts.
⁴ Centre for Experimental Medicine, Queen's University of Belfast, Belfast, United Kingdom.
⁵ Casey Eye Institute, Oregon Health and Sciences University, Portland, Oregon.
⁶ Retina Associates of Cleveland, Cleveland, Ohio.
⁷ Vitreous Retina Macula Consultants of New York, New York, New York.
⁸ Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey.

PMID: 31047572
DOI: 10.1016/j.oret.2016.10.018

Abstract

Purpose: To assess anatomic and visual outcomes of ocriplasmin use for symptomatic vitreomacular adhesion (VMA).

Design: Retrospective chart review.

Methods: Macula Society members were surveyed online to collect data on ocriplasmin for symptomatic VMA. Clinical and optical coherence tomography data were collected using standardized data entry forms.

Results: There were 208 patients (208 eyes) with symptomatic VMA followed at least 3 weeks after receiving ocriplasmin. At baseline, VMA was focal (<1500 μm) in 179 eyes (86%), broad in 9 eyes (4%), and not reported in 20 eyes (10%). A full-thickness macular hole (MH) was present in 75 eyes (36%); size was <400 μm in 62 eyes (82%). Baseline mean visual acuity was approximately 20/63. Of the 204 eyes with ≥12 weeks follow-up, pars plana vitrectomy (PPVx) was performed in 12 (6%) by 4 weeks, 31 (15%) by 12 weeks, and 64 (31%) by the last visit. VMA had resolved by 12 weeks with ocriplasmin alone in 83 of 191 eyes (43%) by week 12 and in 148 of 200 eyes (74%) by the last visit, including eyes undergoing PPVx. Among eyes with a baseline MH, closure was achieved with ocriplasmin alone in 10 of 65 (15%) by 1 week, 26 of 74 (35%) by 4 weeks, and 30 of 75 (40%) at the last visit. Mean change in visual acuity at the last visit compared with baseline was -0.06±0.40 logarithm of the minimum angle of resolution (logMAR) (modest vision improvement) (P = 0.03). At the last visit, visual acuity improved by ≥2 lines in 69 eyes (35%) and by ≥3 lines in 54 eyes (27%). Visual acuity decreased ≥2 lines in 35 eyes (18%) and by 3 lines in 27 eyes (14%) at the final visit. Complications included photopsias (15%), dimness of vision (14%), decreased color vision (10%), MH development (5%), macular retinal pigment epithelium atrophy (2.7%), retinal detachment (1.9%), and retinal tear (1.4%). No endophthalmitis cases were reported.

Conclusions: Physician-reported outcomes on ocriplasmin use confirmed VMA release in 45% and closure of MH in 40% of eyes without PPVx. Visual acuity decreased in approximately 20% of eyes. Adverse events were not infrequent and suggest caution when considering ocriplasmin use.