Ocriplasmin use for vitreomacular traction and macular hole: A meta-analysis and comprehensive review on predictive factors for vitreous release and potential complications

Chatziralli, Irini; Theodossiadis, George; Xanthopoulou, Paraskevi; Miligkos, Michael; Sivaprasad, Sobha; Theodossiadis, Panagiotis

doi:10.1007/s00417-016-3363-5

Cited by 30 publications

(48 citation statements)

References 63 publications

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“…The overall success rate was 47.2% and comparable to previous publications with an average success rate of 46% 6. We were able to confirm that the factors, age, gender, VMT diameter, ERM formation and lens status, had a statistically significant impact on therapeutic success 4 5 7 16.…”

Section: Discussionsupporting

confidence: 84%

Calculating the individual probability of successful ocriplasmin treatment in eyes with VMT syndrome: a multivariable prediction model from the EXPORT study

et al. 2017

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Section: Discussionsupporting

confidence: 84%

Calculating the individual probability of successful ocriplasmin treatment in eyes with VMT syndrome: a multivariable prediction model from the EXPORT study

et al. 2017

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“…Given that factors associated with VMT release were reported by various authors, Chatziralli et al performed a meta-analysis to determine pooled odds ratios and confidence intervals (CI) for each factor reported to be associated with VMT release in the literature [15]. The following results were noted: age <65 years (OR 2.69, 95% CI 1.79–4.03), female gender (OR 2.37, 95% CI 1.23–4.57), adhesion diameter <1500 μm (OR 7.85, 95% CI 3.80–16.24), phakic lens status (OR 3.02, 95% CI 2.02–4.50), absence of ERM (OR 4.75, 95% CI 3.06–7.37), and FTMH size <250 μm (OR 2.25, 95% CI 1.12–4.53).…”

Section: ‘Real-world’ Clinical Outcomes and Patient Selectionmentioning

confidence: 99%

Ocriplasmin for Treatment of Vitreomacular Traction: An Update

Khan

Haller

2016

Ophthalmol Ther

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Pharmacologic vitreolysis with ocriplasmin, a 27 kilodalton serine protease, is an effective nonsurgical treatment option for vitreomacular traction (VMT). Data from phase III clinical studies, including the Microplasmin for Intravitreal Injection—Traction Release without Surgical Treatment (MIVI-TRUST) and Ocriplasmin for Treatment for Symptomatic Vitreomacular Adhesion Including Macular Hole (OASIS) studies, have demonstrated the treatment efficacy of ocriplasmin for VMT and full-thickness macular hole (FTMH). Subgroup analysis of these clinical trials as well as post-marketing clinical series have aided in patient selection by identifying features associated with successful pharmacologic release of VMT with ocriplasmin, including adhesion diameter ≤1500 μm, absence of epiretinal membrane, phakic status, and age younger than 65. As a first-in-class therapeutic, ocriplasmin and its side effects have been carefully monitored by the vitreoretinal community. The following categories of related or possibly related adverse events have been identified: acute reduction in visual acuity, ERG changes, dyschromatopsia, retinal tear or detachment, lens subluxation or phacodonesis, abnormal pupillary reflex, retinal vascular changes, and OCT ellipsoid zone alterations. Adverse events have almost all been transient with restoration of visual acuity; however, in select patients, alterations may persist.

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“…12 However, after its commercial availability, clinical success rates of traction release varied extensively between different centers, which could indicate that the injection technique during administration of the drug is important. 13 Ocriplasmin shows significant autolysis, retaining only 15% of its activity after 6 hours.…”

mentioning

confidence: 99%

Intravitreally Injected Fluid Dispersion: Importance of Injection Technique

Willekens

Reyns²,

Diricx³

et al. 2017

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. The purpose of this study was to evaluate the dispersion of intravitreally injected solutions and investigate the influence of varying injection techniques.METHODS. This was a prospective study using enucleated porcine eyes and ultra-highresolution computed tomography (UHRCT) scanning to visualize iomeprol intravitreal dispersion. Sixty eyes were divided over 12 different groups according to the injection procedure: fast (2 seconds) or slow (10 seconds) injection speed and needle tip location (6-and 12-mm needle shaft insertion or premacular tip placement verified by indirect ophthalmoscopy). For each of these combinations, eyes were either injected with the combination of V20I (which is an analogue of ocriplasmin) and iomeprol or iomeprol alone. Distance to the macula and volume measurements were performed at 1, 2, 3, and 5 hours after injection.RESULTS. The measured contrast bolus volume increases slowly over time to an average of 0.70 (P ¼ 0.03), 1.04 (P ¼ 0.006), and 0.79 (P ¼ 0.0001) cm 3 5 hours after the injection for the 6-mm needle shaft insertion, 12-mm needle shaft insertion, and premacular needle tip placement, respectively. The distance to the macular marker was significantly lower for premacular needle tip placement injections compared with 6-and 12-mm needle shaft insertion depths.CONCLUSIONS. Ultra-high-resolution computed tomography with three-dimensional reconstruction offers the possibility to study the dispersion of intravitreally injected solutions in a noninvasive manner. Intravitreal premacular solution delivery is possible with an indirect ophthalmoscope-guided injection technique and significantly reduces the time to reach the posterior pole in respect to 6-and 12-mm needle insertion depths. The speed of injection does not influence dispersion significantly.

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Ocriplasmin use for vitreomacular traction and macular hole: A meta-analysis and comprehensive review on predictive factors for vitreous release and potential complications

Cited by 30 publications

References 63 publications

Calculating the individual probability of successful ocriplasmin treatment in eyes with VMT syndrome: a multivariable prediction model from the EXPORT study

Calculating the individual probability of successful ocriplasmin treatment in eyes with VMT syndrome: a multivariable prediction model from the EXPORT study

Ocriplasmin for Treatment of Vitreomacular Traction: An Update

Intravitreally Injected Fluid Dispersion: Importance of Injection Technique

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