TRANSIENT VISION LOSS AFTER OCRIPLASMIN INJECTION

Purpose: Transient vision loss is a poorly understood complication of ocriplasmin injection. Methods: The authors performed a retrospective medical records review of consecutive patients who received ocriplasmin for the treatment of vitreomacular adhesion at The George Washington University Department of Ophthalmology and the Virginia Retinal Center from January 1, 2013, to March 1, 2014, and who had at least 28 days of follow-up. Ellipsoid zone loss on optical coherence tomography was analyzed using the National Institutes of Health's Medical Imaging, Processing, Analysis, and Visualization (MIPAV) software. Results: Ten patients received ocriplasmin injection. Three of the 10 patients (30%) had release of vitreomacular adhesion, and 8 of the 10 (80%) experienced vision loss within the first month. Average baseline visual acuity was 66 Early Treatment Diabetic Retinopathy Study letters. Average visual acuity at Weeks 1, 2, 3, and 4 was 62, 43, 57, and 56 Early Treatment Diabetic Retinopathy Study letters, respectively. Average final visual acuity was 58 Early Treatment Diabetic Retinopathy Study letters. Ellipsoid loss occurred in 5 patients and reached a nadir (-36.9% decrease from baseline) 2 weeks later. Conclusion: Vision loss after ocriplasmin occurred in the majority of patients and was correlated with loss of the ellipsoid layer on optical coherence tomography. More data are needed to analyze this side effect.