Treatment of vitreomacular traction with ocriplasmin in a non‐reimbursed setting

Abstract

AbstractPurpose Vitreomacular adhesion can lead to vitreomacular traction (VMT) and macular hole (MH) formation. Intravitreal ocriplasmin provides a non‐surgical solution to release VMT with or without macular hole. A series of 37 patients treated with ocriplasmin is presented. Since ocriplasmin was used in a non‐reimbursed setting, the injection was only recommended when a high success chance was anticipated (e.g. excluding patients with a concomitant epiretinal membrane).Methods An observational trial was conducted on 37 patients with VMT +/‐ MH treated with ocriplasmin with a minimal follow up time of 28 days. Patients had OCT scans of the macular and papillary region prior to the treatment and regularly in the following month. Data on papillary changes were also recorded by Heidelberg Retinal Tomography.Results Overall, 38 eyes of 37 patients were treated (27 with VMT and 11 with VMT+MH). VMT resolved in 28 cases (74%) and macular holes closed in 4 cases (36%). The cup/disc ratio transiently became smaller, associated with a small increase in retinal nerve fiber layer thickness. Interestingly, formation of transient subretinal fluid was observed in the subfoveal and peripapillar region in some patients and a subfoveal drusenoid deposit disappeared in two patients after injection.Conclusion A high success rate of VMT release can be obtained after injection of ocriplasmin when patients are carefully selected. Further research on observed transient changes in the appearance of subretinal fluid and the peripapillary nerve fiber layer thickness is needed.