Treatment Outcomes and Spectral-Domain Optical Coherence Tomography Findings of Eyes With Symptomatic Vitreomacular Adhesion Treated With Intravitreal Ocriplasmin

Purpose To determine treatment outcomes of intravitreal ocriplasmin in symptomatic vitreomacular adhesion. Design Retrospective interventional case series. Methods setting : Private practice. study population : Thirty-five eyes (35 subjects) with symptomatic vitreomacular adhesion. intervention/observation : Intravitreal ocriplasmin injection from February to November 2013. main outcome measure : Vitreomacular adhesion resolution rate. Secondary endpoints included postinjection visual acuity and rates of outer retinal attenuation and full-thickness macular hole (MH) closure. Results The 35 subjects included were of mean age 69 years, 66% female, and 71% phakic. Eleven subjects (31%) had macular comorbidities. Average adhesion diameter was 571 μm, with mean 7.9 months duration of symptoms. Nine subjects (26%) had epiretinal membrane and 6 (17%) had MH (mean diameter 186 μm). Mean preinjection logarithm of the minimal angle of resolution visual acuity was 0.46, and improved to 0.33 at final follow-up. Fifteen eyes (43%) achieved adhesion release at mean 10 days post injection. One of 6 MH (17%) closed. Transient outer retinal attenuation occurred in 10 of 35 cases (29%), with 8 of 10 (80%) achieving adhesion release. One subject (3%) developed a retinal detachment. Adhesion resolution was more likely in patients with younger age ( P = .04), absence of comorbidities ( P = .02), small adhesion diameter ( P = .005), short adhesion duration ( P = .03), and transient outer retinal attenuation ( P = .008). Conclusions Intravitreal ocriplasmin efficacy in the private practice setting, while including patients with macular comorbidities, is similar to that of previous studies. Transient toxicity to the outer retina occurs frequently—typically with adhesion resolution—necessitating careful postinjection spectral-domain optical coherence tomography monitoring.