Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on sleep in brain health

LIVE: Thursday 2nd May 2024, 18:00-19:30 (CEST)

Quality sleep is essential for health. But what happens to our brains when sleep patterns are disturbed? Join our experts to explore the interplay between sleep disruption and neurological diseases, and the questions that you need to be asking your patients to help you prevent the harmful effects of sleep deprivation.
ADVANCED SEARCH
Log in
Top
Graefe's Archive for Clinical and Experimental Ophthalmology
Published in: Graefe's Archive for Clinical and Experimental Ophthalmology 7/2016

01-07-2016 | Review Article

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

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

Published in: Graefe's Archive for Clinical and Experimental Ophthalmology | Issue 7/2016

Login to get access

Abstract

Purpose

We aimed to provide a meta-analysis of the factors affecting vitreomacular traction (VMT) resolution after ocriplasmin use. A comprehensive systematic review of the complications after ocriplasmin use for VMT and macular hole was also done.

Methods

A literature search in PubMed was performed for studies about ocriplasmin published before 30 June 2015. Then a meta-analysis of the factors affecting the VMT resolution after ocriplasmin use was done, providing the pooled odds ratios for each factor and 95 % confidence intervals (CIs). We also described the potential adverse events after ocriplasmin use in a systematic review.

Results

A total of 194 abstracts were screened and 19 eligible studies were included in the meta-analysis. Age <65 years, female gender, vitreomacular adhesion diameter <1500 μm, phakic lens status and epiretinal membrane absence were found as positive predictive factors for VMT resolution, while macular hole size <250 μm was significantly associated with macular hole closure at the meta-analytical level. Various complications after ocriplasmin use were reported by frequency, including mainly vitreous floaters, photopsias, visual acuity decrease, ellipsoid zone changes, subretinal fluid development, enlargement of macular hole, anterior segment changes and electroretinogram alterations. It has to be noted that significant methodological weaknesses were identified, such as the absence of control groups or lack of transparency in the recruitment process and the examination procedure.

Conclusions

It is important to carefully select patients for ocriplasmin injection, taking into account the various predictive factors for VMT resolution. Patients should be informed about the potential adverse events of ocriplasmin, although they mainly seemed to be transient and usually mild/moderate in severity, suggesting that ocriplasmin is a safe and effective new treatment alternative for VMT and macular hole. However, due to the limited study quality, the uncertainty concerning the efficacy of this new approach is increased.
Literature
1.
2.
3.
Duker JS, Kaiser PK, Binder S, de Smet MD, Gaudric A, Reichel E, Sadda SR, Sebag J, Spaide RF, Stalmans P (2013) The International Vitreomacular Traction Study Group classification of vitreomacular adhesion, traction, and macular hole. Ophthalmology 120:2611–2619CrossRefPubMed
4.
Stalmans P, Duker JS, Kaiser PK, Heier JS, Dugel PU, Gandorfer A, Sebag J, Haller JA (2013) Oct-based interpretation of the vitreomacular interface and indications for pharmacologic vitreolysis. Retina 33:2003–2011CrossRefPubMed
5.
John VJ, Flynn HW Jr, Smiddy WE, Carver A, Leonard R, Tabandeh H, Boyer DS (2014) Clinical course of vitreomacular adhesion managed by initial observation. Retina 34:442–446CrossRefPubMed
6.
Dimopoulos S, Bartz-Schmidt KU, Gelisken F, Januschowski K, Ziemssen F (2015) Rate and timing of spontaneous resolution in a vitreomacular traction group: should the role of watchful waiting be re-evaluated as an alternative to ocriplasmin therapy? Br J Ophthalmol 99:350–353CrossRefPubMed
7.
Mester V, Kuhn F (2000) Internal limiting membrane removal in the management of full-thickness macular holes. Am J Ophthalmol 129:769–777CrossRefPubMed
8.
Kuppermann BD (2012) Ocriplasmin for pharmacologic vitreolysis. Retina 32:225–228CrossRef
9.
Syed YY, Dhillon S (2013) Ocriplasmin: a review of its use in patients with symptomatic vitreomacular adhesion. Drugs 73:1617–1625CrossRefPubMed
10.
Stalmans P, Benz MS, Gandorfer A, Kampik A, Girach A, Pakola S, Haller JA, MIVI-TRUST Study Group (2012) Enzymatic vitreolysis with ocriplasmin for vitreomacular traction and macular holes. N Engl J Med 367:606–615CrossRefPubMed
11.
Haller JA, Stalmans P, Benz MS, Gandorfer A, Pakola SJ, Girach A, Kampik A, Jaffe GJ, Toth CA, MIVI-TRUST Study Group (2015) Efficacy of intravitreal ocriplasmin for treatment of vitreomacular adhesion: subgroup analyses from two randomized trials. Ophthalmology 122:117–122CrossRefPubMed
12.
Trikalinos TA, Trow P, Schmid CH (2013) Simulation-Based Comparison of Methods for Meta-Analysis of Proportions and Rates. Methods Research Report. (Prepared by the Tufts Medical Center Evidence-based Practice Center under Contract No. 290-2007-10055-I.) AHRQ Publication No. 13(14)-EHC084-EF. Rockville, MD: Agency for Healthcare Research and Quality www.​effectivehealthc​are.​ahrq.​gov/​reports/​final.​cfm. Accessed 09 Sep 2015.
13.
14.
15.
Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP, Clarke M, Devereaux PJ, Kleijnen J, Moher D (2009) The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. J Clin Epidemiol 62:1–34CrossRef
16.
Stroup DF, Berlin JA, Morton SC, Olkin I, Williamson GD, Rennie D, Moher D, Becker BJ, Sipe TA, Thacker SB (2000) Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. JAMA 283:2008–2012CrossRefPubMed
17.
Varma R, Haller JA, Kaiser PK (2015) Improvement in Patient-Reported Visual Function After Ocriplasmin for Vitreomacular Adhesion: Results of the Microplasmin for Intravitreous Injection-Traction Release Without Surgical Treatment (MIVI-TRUST) Trials. JAMA Ophthalmol 133:997–1004CrossRefPubMed
18.
Gandorfer A, Benz MS, Haller JA, Stalmans P, Pakola SJ, Girach A, Kampik A, Toth CA, Jaffe GJ, MIVI-TRUST Study Group (2015) Association between anatomical resolution and functional outcomes in the mivi-trust studies using ocriplasmin to treat symptomatic vitreomacular adhesion/vitreomacular traction, including when associated with macular hole. Retina 35:1151–1157CrossRefPubMed
19.
de Smet MD, Gandorfer A, Stalmans P, Veckeneer M, Feron E, Pakola S, Kampik A (2009) Microplasmin intravitreal administration in patients with vitreomacular traction scheduled for vitrectomy: the MIVI I trial. Ophthalmology 116:1349–1355CrossRefPubMed
20.
Stalmans P, Delaey C, de Smet MD, van Dijkman E, Pakola S (2010) Intravitreal injection of microplasmin for treatment of vitreomacular adhesion: results of a prospective, randomized, sham-controlled phase II trial (the MIVI-IIT trial). Retina 30:1122–1127CrossRefPubMed
21.
22.
Johnson MW, Fahim AT (2015) Understanding the adverse effects of ocriplasmin -reply. JAMA Ophthalmol 133:230CrossRefPubMed
23.
Tibbetts MD, Reichel E, Witkin AJ (2015) Understanding the adverse effects of ocriplasmin - reply. JAMA Ophthalmol 133:229–230CrossRefPubMed
24.
Hong J, Deng SX, Xu J (2012) Enzymatic vitreolysis with ocriplasmin for vitreomacular traction and macular holes. N Engl J Med 367:2053PubMed
25.
Rao RC, Dlouhy BJ (2012) Enzymatic vitreolysis with ocriplasmin for vitreomacular traction and macular holes. N Engl J Med 367:2053PubMed
26.
Huang J, Wen D, Wang Q (2012) Enzymatic vitreolysis with ocriplasmin for vitreomacular traction and macular holes. N Engl J Med 367:2052–2053CrossRefPubMed
27.
Novack RL, Staurenghi G, Girach A, Narendran N, Tolentino M (2015) Safety of intravitreal ocriplasmin for focal vitreomacular adhesion in patients with exudative age-related macular degeneration. Ophthalmology 122:796–802CrossRefPubMed
28.
Maier M, Abraham S, Frank C, Feucht N, Lohmann CP (2015) Ocriplasmin as a treatment option for symptomatic vitreomacular traction with and without macular hole: First clinical experiences. Ophthalmologe 112:990–994CrossRefPubMed
29.
Steel DH, Sandinha MT, White K (2015) The Plane of Vitreoretinal Separation and Results of Vitrectomy Surgery in Patients Given Ocriplasmin for Idiopathic Macular Hole. Invest Ophthalmol Vis Sci 56:4038–4044CrossRefPubMed
30.
Quezada-Ruiz C, Pieramici DJ, Nasir M, Rabena M, Steinle N, Castellarin AA, Dhoot D, Couvillion S, See RF, Avery RL (2015) Outer retina reflectivity changes on sd-oct after intravitreal ocriplasmin for vitreomacular traction and macular hole. Retina 35:1144–1150CrossRefPubMed
31.
Chatziralli I, Theodossiadis G, Parikakis E, Datseris I, Theodossiadis P (2016) Real-life experience after intravitreal ocriplasmin for vitreomacular traction and macular hole: a spectral-domain optical coherence tomography prospective study. Graefes Arch Clin Exp Ophthalmol 254:223–233CrossRefPubMed
32.
Reiss B, Smithen L, Mansour S (2015) Transient vision loss after ocriplasmin injection. Retina 35:1107–1110CrossRefPubMed
33.
Willekens K, Abegão Pinto L, Vandewalle E, Stalmans I, Stalmans P (2015) Improved efficacy of ocriplasmin for vitreomacular traction release and transient changes in optic disk morphology. Retina 35:1135–1143CrossRefPubMed
34.
Meyer JC, Shah GK, Blinder KJ, Waheed NK, Reichel E, Stalmans P, Singer M, Tewari A (2015) Early evolution of the vitreomacular interface and clinical efficacy after ocriplasmin injection for symptomatic vitreomacular adhesion. Ophthalmic Surg Lasers Imaging Retina 46:209–216CrossRefPubMed
35.
Sharma P, Juhn A, Houston SK, Fineman M, Chiang A, Ho A, Regillo C (2015) Efficacy of intravitreal ocriplasmin on vitreomacular traction and full-thickness macular holes. Am J Ophthalmol 159:861–867CrossRefPubMed
36.
Hager A, Seibel I, Riechardt A, Rehak M, Joussen AM (2015) Does ocriplasmin affect the RPE-photoreceptor adhesion in macular holes? Br J Ophthalmol 99:635–638CrossRefPubMed
37.
Warrow DJ, Lai MM, Patel A, Raevis J, Berinstein DM (2015) Treatment outcomes and spectral-domain optical coherence tomography findings of eyes with symptomatic vitreomacular adhesion treated with intravitreal ocriplasmin. Am J Ophthalmol 159:20–30CrossRefPubMed
38.
Chin EK, Almeida DR, Sohn EH, Boldt HC, Mahajan VB, Gehrs KM, Russell SR, Folk JC (2014) Incomplete vitreomacular traction release using intravitreal ocriplasmin. Case Rep Ophthalmol 5:455–462CrossRefPubMedPubMedCentral
39.
Itoh Y, Kaiser PK, Singh RP, Srivastava SK, Ehlers JP (2014) Assessment of retinal alterations after intravitreal ocriplasmin with spectral-domain optical coherence tomography. Ophthalmology 121:2506–2507CrossRefPubMedPubMedCentral
40.
Miller JB, Kim LA, Wu DM, Vavvas DG, Eliott D, Husain D (2014) Ocriplasmin for treatment of stage 2 macular holes: early clinical results. Ophthalmic Surg Lasers Imaging Retina 45:293–297CrossRefPubMedPubMedCentral
41.
Knudsen VM, Kozak I (2014) A retrospective study of a single practice use of ocriplasmin in the treatment of vitreomacular traction. Saudi J Ophthalmol 28:139–144CrossRefPubMedPubMedCentral
42.
Lommatzsch AP, Gutfleisch M, Dietzel M, Heimes B, Spital G, Böhme M, Bornfeld N, Pauleikhoff D (2014) Initial clinical experience in the treatment of vitreomacular traction and macular holes with ocriplasmin. Klin Monbl Augenheilkd 231:909–914CrossRefPubMed
43.
Singh RP, Li A, Bedi R, Srivastava S, Sears JE, Ehlers JP, Schachat AP, Kaiser PK (2014) Anatomical and visual outcomes following ocriplasmin treatment for symptomatic vitreomacular traction syndrome. Br J Ophthalmol 98:356–360CrossRefPubMed
44.
Kim BT, Schwartz SG, Smiddy WE, Doshi RR, Kovach JL, Berrocal AM, Moshfeghi AA, Fortun JA (2013) Initial outcomes following intravitreal ocriplasmin for treatment of symptomatic vitreomacular adhesion. Ophthalmic Surg Lasers Imaging Retina 44:334–343CrossRefPubMed
45.
Casswell E, Fernandez-Sanz G, Mitry D, Luk S, Zakir R (2014) Macular Hole Progression following Ocriplasmin Intravitreal Injection. Case Rep Ophthalmol Med 2014:403461PubMedPubMedCentral
46.
47.
48.
Keller J, Haynes RJ (2015) Zonular Dehiscence at the Time of Combined Vitrectomy and Cataract Surgery After Intravitreal Ocriplasmin Injection. JAMA Ophthalmol 133:1091–1092CrossRefPubMed
49.
Barteselli G, Carini E, Invernizzi A, Ratiglia R, Viola F (2016) Early panretinal abnormalities on fundus autofluorescence and spectral domain optical coherence tomography after intravitreal ocriplasmin. Acta Ophthalmol 94:160–162CrossRef
50.
Han IC, Scott AW (2015) Sterile endophthalmitis after intravitreal ocriplasmin injection: report of a single case. Retin Cases Brief Rep 9:242–244CrossRefPubMed
51.
Chuo JY, Lee TY, Hollands H, Morris AH, Reyes RC, Rossiter JD, Meredith SP, Maberley DA (2006) Risk factors for posterior vitreous detachment: a case–control study. Am J Ophthalmol 142:931–937CrossRefPubMed
52.
Hilford D, Hilford M, Mathew A, Polkinghorne PJ (2009) Posterior vitreous detachment following cataract surgery. Eye 23:1388–1392CrossRefPubMed
53.
Reiss B, Smithen L, Mansour S (2015) Acute vision loss after ocriplasmin use. Retin Cases Brief Rep 9:168–169CrossRefPubMed
54.
Fahim AT, Khan NW, Johnson MW (2014) Acute panretinal structural and functional abnormalities after intravitreous ocriplasmin injection. JAMA Ophthalmol 132:484–486CrossRefPubMed
55.
Freund KB, Shah SA, Shah VP (2013) Correlation of transient vision loss with outer retinal disruption following intravitreal ocriplasmin. Eye 27:773–774CrossRefPubMedPubMedCentral
56.
DaCosta J, Younis S (2014) Transient visual loss and delayed resolution of vitreomacular traction after intravitreal ocriplasmin. Drug Healthc Patient Saf 6:175–178CrossRefPubMedPubMedCentral
57.
Quezada Ruiz C, Pieramici DJ, Nasir M, Rabena M, Avery RL (2015) Severe acute vision loss, dyschromatopsia, and changes in the ellipsoid zone on sd-oct associated with intravitreal ocriplasmin injection. Retin Cases Brief Rep 9:145–148CrossRefPubMed
58.
59.
de Smet MD, Jonckx B, Vanhove M, van Calster J, Stalmans P, Stassen J (2010) Pharmacokinetics of ocriplasmin in vitreous. Invest Ophthalmol Vis Sci 53:8208–8213CrossRef
60.
Stalmans P, Girach A (2013) Vitreous levels of active ocriplasmin following intravitreal injection: results of an ascending exposure trial. Invest Ophthalmol Vis Sci 54:6620–6627CrossRefPubMed
61.
Thanos A, Hernandez-Siman J, Marra KV, Arroyo JG (2014) Reversible vision loss and outer retinal abnormalities after intravitreal ocriplasmin injection. Retin Cases Brief Rep 8:330–332CrossRefPubMed
62.
Tibbetts MD, Reichel E, Witkin AJ (2014) Vision loss after intravitreal ocriplasmin: correlation of spectral-domain optical coherence tomography and electroretinography. JAMA Ophthalmol 132:487–490CrossRefPubMed
63.
Ziemssen F, Bartz-Schmidt KU, Dimopoulos S (2016) Knowledge of vitreomacular traction (VMT) scenarios: Is doing nothing still a beneficial alternative and, if so, when? Graefes Arch Clin Exp Ophthalmol
64.
Stalmans P (2016) A retrospective cohort study in patients with tractional diseases of the vitreomacular interface (ReCoVit). Graefes Arch Clin Exp Ophthalmol
Metadata
Title
Ocriplasmin use for vitreomacular traction and macular hole: A meta-analysis and comprehensive review on predictive factors for vitreous release and potential complications
Authors
Irini Chatziralli
George Theodossiadis
Paraskevi Xanthopoulou
Michael Miligkos
Sobha Sivaprasad
Panagiotis Theodossiadis
Publication date
01-07-2016
Publisher
Springer Berlin Heidelberg
Published in
Graefe's Archive for Clinical and Experimental Ophthalmology / Issue 7/2016
Print ISSN: 0721-832X
Electronic ISSN: 1435-702X
DOI
https://doi.org/10.1007/s00417-016-3363-5

Other articles of this Issue 7/2016

Graefe's Archive for Clinical and Experimental Ophthalmology 7/2016 Go to the issue

Basic Science

Bit1—a potential positive regulator of epithelial–mesenchymal transition in lens epithelial cells

Trauma

Traumatic myopia secondary to ciliary spasm after blunt eye trauma and reconsideration of its pathogenesis

Neurophthalmology

Factors influencing the pupillary light reflex in healthy individuals

Letter to the Editor

Comment on: “Effect of a topical nonsteroidal anti-inflammatory agent (0.1 % pranoprofen) on acute central serous chorioretinopathy”

Glaucoma

Progression of primary open angle glaucoma in asymmetrically myopic eyes

Letter to the Editor

Re: Cho et al. “Long-term visual outcome and prognostic factors of intravitreal anti-vascular endothelial growth factor treatment for retinal angiomatous proliferation”