Does ocriplasmin affect the RPE–photoreceptor adhesion in macular holes?

Hager, A; Seibel, Ira; Riechardt, Aline I.; Rehák, Matúš; Joussen, Antonia M.

doi:10.1136/bjophthalmol-2014-305620

Cited by 31 publications

(27 citation statements)

References 5 publications

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“…9 This trans-retinal route would explain the observation of sub-retinal fluid around the optic nerve head including on the nasal side of the nerve. 7 Further evidence for an adverse effect on retinal adhesion is that all eight of the BEAVRS cases with a retinal tear went on to develop a retinal detachment, whereas natural history studies of spontaneous posterior vitreous detachment suggest that only 30-50% of tears progress to retinal detachment. [10][11][12] The 46.9% incidence of widening of the FTMH basal diameter in failed ocriplasmin cases could have implications for visual outcomes, as increased basal diameter has previously been found to predict worse post-operative vision; 13 however, this was not found in the MIVI TRUST trials where the acuity improvement in failed ocriplasmin eyes was the same as in placebo treated eyes.…”

Section: Discussionmentioning

confidence: 99%

Real world outcomes of ocriplasmin use by members of the British and Eire Association of Vitreoretinal Surgeons

Haynes

Yorston

Laidlaw

et al. 2016

Eye

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Purpose To describe a survey of the use of ocriplasmin by members of the British and Eire Association of VitreoRetinal Surgeons (BEAVRS) for VitreoMacular Traction (VMT) and Full Thickness Macular Hole (FTMH) and compare it to published MIVI TRUST trial data. Methods All 173 BEAVRS members were contacted by email in October 2014 requesting data on all cases treated with ocriplasmin up to that date. The total number of cases, FTMH closure rate, VMT release rate and the frequency of adverse events were recorded. Results were compared with trial data. Results 48 members responded reporting results from 241 eyes. The respective BEAVRS and MIVI TRUST trial closure rates for small FTMHs were 42.1 and 58.3% (P = 0.09) and for medium FTMH 12.7 and 36.7% (P = 0.01). The respective VMT release rates were 34.1 and 37.4% (P = NS). Retinal detachment was observed in 3.3% of the BEAVRS cohort compared with 0.4% in MIVI TRUST. Reduction in visual acuity to o6/60 was observed in 5.8% of the BEAVRS cohort and 0.6% in MIVI TRUST. Other complications not reported in the MIVI TRUST trial included an increase in FTMH basal diameter following unsuccessful ocriplasmin use in 46.9% of BEAVRS cases and zonular instability at the time of subsequent phacoemulsification in 2.4%. Conclusion Macular hole closure rates were lower in the BEAVRS survey than published in the MIVI TRUST trial data. The incidence of adverse events was greater than previously reported. The reasons for these disparities are unknown but could include positive reporting bias inherent to retrospective surveys, treatment and population differences.

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Section: Discussionmentioning

confidence: 99%

Real world outcomes of ocriplasmin use by members of the British and Eire Association of Vitreoretinal Surgeons

Haynes

Yorston

Laidlaw

et al. 2016

Eye

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“…Dado que la laminina constituye una familia de glucoproteínas que forman parte del andamiaje estructural de las membranas basales [15][16][17][18] y la ocriplasmina ejerce una actividad proteolítica en la laminina, el propósito de este estudio comprendía investigar el efecto enzimático de la ocriplasmina en las propiedades biomecánicas de la MLI. Incluimos muestras de MLI extraídas de ojos sometidos a vitrectomía con disección de la MLI con y sin tinción de la MLI utilizando ABG tras recibir sin éxito tratamiento con ocriplasmina y las comparamos con muestras extraídas de ojos que no habían recibido inyección de ocriplasmina antes de someterse a cirugía.…”

Section: Discussionunclassified

Propiedades biomecánicas de la membrana limitante interna tras recibir tratamiento intravítreo con ocriplasmina

Vielmuth¹,

Schumann²,

Spindler³

et al. 2017

Ophthalmologica

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de las muestras de MLI extraídas de ojos con o sin tratamiento con ocriplasmina. Las áreas onduladas de la parte de la retina presentaron una mayor rigidez que la parte del vítreo de la MLI. La cartografía topográfica tanto de la parte del vítreo como de la retina de la MLI no mostró ninguna alteración aparente de la morfología en ojos tratados con ocriplasmina en comparación con los ojos no tratados. La tinción con azul brillante conllevó un aumento de la rigidez tisular. Conclusiones: Las inyecciones intravítreas de ocriplasmina no varían las propiedades biomecánicas de la MLI humana. No existen pruebas de un posible efecto enzimático que interfiera con la rigidez de esta membrana basal. © 2017 S. Karger AG, Basel IntroducciónLa ocriplasmina (Jetrea ® , ThromboGenics, Lovaina, Bélgica) constituye una forma truncada sin especificar y recombinante de la serina proteasa plasmina que posee actividad proteolítica frente a la laminina y fibronectina, ambos componentes principales de la interfase vitreore- Palabras clave Membrana limitante interna · Ocriplasmina · Tracción vitreomacularResumen Objetivo: Evaluar la rigidez de la membrana limitante interna (MLI) humana y evaluar los posibles cambios de las propiedades mecánicas tras administrar una inyección intravítrea de ocriplasmina para tratar la tracción vitreomacular. Métodos: Este estudio se compone de una serie de casos intervencionales y comparativos de 12 muestras de MLI extraídas mediante cirugía y obtenidas de forma consecutiva de 9 ojos de 9 pacientes después de someterse sin éxito a vitreólisis farmacológica con ocriplasmina. Durante el mismo periodo de tiempo, 16 muestras de otros 13 ojos sin tratamiento con ocriplasmina se obtuvieron mediante vitrectomía y sirvieron como controles. Todos los pacientes presentaron agujeros maculares o tracción vitreomacular y se sometieron a vitrectomía con disección de la MLI tanto con tinción con azul brillante (AB) como sin ella. Todas las muestras se analizaron con un microscopio de fuerza atómi-ca con imágenes de las regiones de 25 × 25 μm. En todas las muestras, se analizaron tanto la parte de la retina como la del vítreo de la MLI. Resultados: La microscopia de fuerza atómi-ca no reveló diferencias significativas en cuanto a elasticidad

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“…Vitrectomy has a significantly higher chance of VMTS resolution and macular hole closure (>90%) when compared to ocriplasmin alone. Yet, the visual outcome seems to be equal between primary vitrectomy and vitrectomy after failure of ocriplasmin [23,24,27] .…”

Section: Discussionmentioning

confidence: 99%

“…Unfortunately, we could not identify a pre-ocriplasmin SD-OCT parameter for the modest visual outcome. There are numerous papers in the literature that report modest visual acuity after ocriplasmin and long-standing subretinal fluid [26,27] and a worse outcome in visual acuity if subretinal fluid persists due to photoreceptor damage. We had only 1 patient with treatment success and preinjection subretinal fluid, which persisted.…”

Section: Discussionmentioning

confidence: 99%

Impact of Preinjection Spectral Domain Optical Coherence Tomography Findings in the Use of Intravitreal Ocriplasmin in a Clinical Setting

Wertheimer¹,

Haritoglou²,

Laubichler³

et al. 2017

Ophthalmologica

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Purpose: To investigate the impact of spectral domain optical coherence tomography (SD-OCT) morphological predictive markers on visual acuity and outcome using ocriplasmin for macular hole and vitreomacular traction syndrome. Methods: A series of 40 patients in a retrospective study received intravitreal ocriplasmin. The primary endpoint was defined as morphological resolution of vitreomacular traction or closure of a macular hole. We analyzed the impact of pre- and postinjection SD-OCT findings on the outcome and visual acuity. Results: Thirteen of the 40 patients benefited from treatment. Statistical correlation between baseline characteristics and outcome revealed that higher foveal thickness (p = 0.018) and nontractional epiretinal membranes (p = 0.05) resulted in a worse outcome. In treatment success best corrected visual acuity gained was 9 (SD 12) letters and in failure 1 (SD 9) letter. We could not observe an influence of preinjection SD-OCT findings and other factors on visual outcome. Conclusion: We could confirm the therapeutic effect of ocriplasmin injections. SD-OCT morphological factors that influence treatment success and visual acuity were determined.

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Does ocriplasmin affect the RPE–photoreceptor adhesion in macular holes?

Cited by 31 publications

References 5 publications

Real world outcomes of ocriplasmin use by members of the British and Eire Association of Vitreoretinal Surgeons

Real world outcomes of ocriplasmin use by members of the British and Eire Association of Vitreoretinal Surgeons

Propiedades biomecánicas de la membrana limitante interna tras recibir tratamiento intravítreo con ocriplasmina

Impact of Preinjection Spectral Domain Optical Coherence Tomography Findings in the Use of Intravitreal Ocriplasmin in a Clinical Setting

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