En face OCT offers prognostic parameters for enzymatic vitreolysis

VIENNA — En face OCT evaluation of the adhesion area may offer a predictive parameter for the success of enzymatic vitreolysis with ocriplasmin, according to a study presented here.

“In our series of patients, we found that the area of adhesion was two times greater in the group of patients who did not achieve VMT resolution,” Pedro Neves, MD, said at the meeting of the European Society of Ophthalmology.

Pedro Neves

He also noted that the overall success rate was higher in this study than in the MIVI-TRUST trial, probably due to better patient selection.

“We included patients with focal VMT less than 1,500 µm, with or without small or medium size macular hole with visual impairment. We excluded severe retinal pathologies such as wet AMD, diabetic retinopathy, high myopia and epiretinal membranes — not all of them, but at least those that were obvious and frank,” Neves said.

After injection, patients were kept in the supine position for 30 to 60 minutes to facilitate early release of the traction. They were followed closely — daily for the first week, then weekly and monthly — with OCT to detect changes in the VMT area and VMT/MH diameter, as well as presence of subretinal fluid or ellipsoid changes. En face OCT was used to obtain cross sections of the area.

“Duration of treatment was 8 months, and we had a 55% release rate, one of them partial. Visual acuity increased from 20/60 to 20/40. The average time until release was 20.8 days, and one case resolved after 56 days,” Neves said.

“Adhesion area analysis seems to be a good intuitive and quantitative method to evaluate these patients,” he said. – by Michela Cimberle

Disclosure: Neves reports no relevant financial disclosures.