Initial Clinical Experiences Using Ocriplasmin for the Treatment of Vitreomacular Traction with or without a Macular Hole

Purpose In vitreomacular traction (VMT), there is abnormal adhesion between the vitreous cortex and the retina, especially in the fovea. Symptoms of VMT include metamorphopsia and a decrease in visual acuity. Since 2013, ocriplasmin (Jetrea (R)) has been approved for treatment of symptomatic vitreomacular traction with or without macular holes (<= 400 mu m). Methods We retrospectively examined twenty-three eyes of twenty-one patients who underwent intravitreal ocriplasmin treatment for symptomatic vitreomacular traction with or without macular holes. Best corrected visual acuity and central retinal thickness (CRT) were measured in advance and after ocriplasmin treatment. The numbers of resolved vitreomacular traction and closed macular holes were documented. Results Vitreomacular traction was resolved in eight of twenty-three eyes (34.8%); in fifteen eyes (65.2%) it was persistent and two of four macular holes were found closed. The average best corrected visual acuity was 0.39 +/- 0.25 logMAR at baseline and 0.41 +/- 0.24 logMAR at the first follow-up visit after injection (p = 0.613). The average CRT was 453.3 +/- 172.7 mu m at baseline, with a slight decrease to 412.0 +/- 212 mu m (p = 0.124). Conclusion Intravitreal injection of ocriplasmin appears is an experimental therapy in patients with symptomatic vitreomacular traction. Patient selection seems to be critically important for the ther-apeutic outcome, whereas greater age, specific VMT morphology and missing chromatopsia seem to be negative predictors.