Abstract
SummaryBackgroundWe 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.MethodsIn 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.ResultsOverall, 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.ConclusionIntravitreal C3F8gas injection is an inexpensive and promising minimally invasive option for the treatment of symptomatic and persistent vitreomacular traction with or without a macular hole. Further larger studies, especially comparing C3F8 gas injection with other treatment options, are needed.
Highlights
Posterior vitreous detachment, typically occurring between the ages of 45 and 65 years, is defined as the separation of the vitreous body from the internal limiting membrane of the retina and is a physiological age-related process [1]
Current treatment options include observation, when patients are either asymptomatic or when symptoms do not aggravate, or medical therapy with ocriplasmin and pars plana vitrectomy, which remains the mainstay of treatment when there is no indication for ocriplasmin or the treatment fails
Data from the Microplasmin for Intravitreal Injection–Traction Release Without Surgical Treatment (MIVI-TRUST) trial showed the nonsurgical success of vitreomacular traction (VMT) release within 28 days in 41.7% of cases, which was statistically significant, and closure of the macular hole (MH) in 30% [3]
Summary
Typically occurring between the ages of 45 and 65 years, is defined as the separation of the vitreous body from the internal limiting membrane of the retina and is a physiological age-related process [1]. When the vitreous fails to detach completely, vitreomacular adhesion (VMA), showing no retinal abnormalities, or vitreomacular traction (VMT), with detectable retinal changes on optical coherence tomography, is the consequence. Data from the Microplasmin for Intravitreal Injection–Traction Release Without Surgical Treatment (MIVI-TRUST) trial showed the nonsurgical success of VMT release within 28 days in 41.7% of cases, which was statistically significant, and closure of the macular hole (MH) in 30% [3]. 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
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