Download PDF
Klin Monbl Augenheilkd 2017; 234(04): 524-526
DOI: 10.1055/s-0043-100559
Der interessante Fall
Georg Thieme Verlag KG Stuttgart · New York

Long-Term Persistence of Subfoveal Fluid Following Ocriplasmin-Treatment of an FTMH

Langfristige Persistenz subfovealer Flüssigkeit nach Ocriplasminbehandlung eines Makulaforamens
S. Tschuppert
1   Department of Retinology, Klinik Pallas, Olten/Switzerland (Director: Prof. Dr. Heinrich Gerding)
,
H. Gerding
1   Department of Retinology, Klinik Pallas, Olten/Switzerland (Director: Prof. Dr. Heinrich Gerding)
2   Department of Ophthalmology, University of Münster (Director: Prof. Dr. N. Eter)
› Author Affiliations
Further Information

Publication History

Publication Date:
10 March 2017 (online)

Also available at
    Permissions and Reprints

Introduction

Ocriplasmin is a recombinant human serine protease that, applied intravitreally, affects proteins, such as laminin and fibronectin, of the interface between the posterior vitreous and the internal limiting membrane to resolve the adhesion [1].

The intravitreal injection of Ocriplasmin for treating symptomatic vitreomacular adhesion (sVMA) was approved for the European Union in the year 2013. The approval was based on the MIVI-TRUST trials, two phase III randomized international placebo-control double-blind studies [2]. These trials showed not just promising treatment of vitreomacular traction (VMT) but also a significant benefit in treating full thickness macular holes (FTMH) with vitreomacular adhesion. Besides treatment of VMT Ocriplasmin was approved for treating small (≤ 250 µm) and medium (≤ 400 µm) FTMH. The studies showed that nonsurgical closure of a macular hole by day 28 was achieved in 40.6 % through the injection of Ocriplasmin [2].

Disintegration of the photoreceptor-RPE contact and new occurring deposition of transient subfoveal fluid is a common side effect after Ocriplasmin use. The fluid usually resorbs spontaneously, generally without permanent structural or functional damage, but persistent retinal changes have been reported [3], [4], [5], [6]. We report a case of unusual postoperative extension and long-term persistence of subfoveal fluid following successful resolution of VMT and successful closure of a FTMH after Ocriplasmin.

 

  • References

  • 1 Syed YY, Dhillon S. Ocriplasmin: A review of its use in patients with symptomatic vitreoumacular adhesion. Drugs 2013; 73: 1617-1625
    CrossrefPubMedGoogle Scholar
  • 2 Stalmans P, Benz MS, Gandorfer A. et al. Enzymatic vitreolysis with ocriplasmin for vitreomacular traction and macular holes. N Engl J Med 2012; 367: 606-615
    CrossrefPubMedGoogle Scholar
  • 3 Tschuppert S, Gerding H. Transient subfoveal fluid and visual loss after ocriplasmin. Klin Monatsbl Augenheilkd 2016; 233: 453-455
    Article in Thieme ConnectPubMedGoogle Scholar
  • 4 Reiss B, Smithen L, Mansour S. Transient vision loss after ocriplasmin injection. Retina 2015; 35: 1107-1110
    CrossrefPubMedGoogle Scholar
  • 5 Singh RP, Li A, Bedi R. et al. Anatomical and visual outcomes following ocriplasmin treatment for symptomatic vitreomacular traction syndrome. Br J Ophthalmol 2014; 98: 356-360
    CrossrefPubMedGoogle Scholar
  • 6 Margo JA, Schocket LS, Klima K. et al. Persistent retinal changes after intravitreal ocriplasmin. Retin Cases Brief Rep 2016; 10: 48-51
    CrossrefPubMedGoogle Scholar
  • 7 Dugel PU, Regillo C, Eliott D. Characterization of anatomic and visual function outcomes in patients with full-thickness macular hole in ocriplasmin phase 3 trials. Am J Ophthalmol 2015; 160: 94-99.e1
    CrossrefPubMedGoogle Scholar