David H W Steel1, Maria T Sandinha2, Kathryn White3. 1. Sunderland Eye Infirmary Queen Alexandra Road, Sunderland, United Kingdom 2Institute of Genetic Medicine, Newcastle University, Newcastle Upon Tyne, United Kingdom. 2. Sunderland Eye Infirmary Queen Alexandra Road, Sunderland, United Kingdom. 3. EM Research Services, Newcastle University, Newcastle Upon Tyne, United Kingdom.
Abstract
PURPOSE: We assessed whether ocriplasmin (OCP) given to patients with idiopathic macular hole (IMH) results in an altered plane of vitreoretinal (VR) separation compared to patients without OCP exposure. METHODS: A prospective study was done of 12 patients with IMH and vitreomacular adhesion (VMA) given OCP. Patients in whom the IMH failed to close underwent vitrectomy with peeling of the internal limiting membrane (ILM). The intraoperative staining pattern of the ILM using Brilliant Blue G (BBG) and examination of the excised ILM with transmission electron microscopy (TEM) were compared to results of a matched cohort of 31 patients with IMH who had not received OCP. RESULTS: Among 12 patients treated with OCP, VMA release occurred in 7 (58%) and hole closure was achieved in 3 (25%). Vitrectomy was done on the nine patients without hole closure. In seven of these nine (78%) the ILM had less than 5% of its vitreous surface covered in residual material on TEM, which was significantly less than in the control group (5/31, 16%, P = 0.001). In two OCP patients, large amounts of vitreous side material were present, but the rim of the hole stained evenly with BBG, suggesting that epiretinal material had avulsed with VR separation, a pattern not seen in any of the control patients. All patients had IMH closure after vitrectomy and visual results were not significantly different from the control group. CONCLUSIONS: Ocriplasmin facilitates more complete VR separation in patients undergoing surgery for IMH, although it does not result in more eccentric epiretinal tissue release.
PURPOSE: We assessed whether ocriplasmin (OCP) given to patients with idiopathic macular hole (IMH) results in an altered plane of vitreoretinal (VR) separation compared to patients without OCP exposure. METHODS: A prospective study was done of 12 patients with IMH and vitreomacular adhesion (VMA) given OCP. Patients in whom the IMH failed to close underwent vitrectomy with peeling of the internal limiting membrane (ILM). The intraoperative staining pattern of the ILM using Brilliant Blue G (BBG) and examination of the excised ILM with transmission electron microscopy (TEM) were compared to results of a matched cohort of 31 patients with IMH who had not received OCP. RESULTS: Among 12 patients treated with OCP, VMA release occurred in 7 (58%) and hole closure was achieved in 3 (25%). Vitrectomy was done on the nine patients without hole closure. In seven of these nine (78%) the ILM had less than 5% of its vitreous surface covered in residual material on TEM, which was significantly less than in the control group (5/31, 16%, P = 0.001). In two OCPpatients, large amounts of vitreous side material were present, but the rim of the hole stained evenly with BBG, suggesting that epiretinal material had avulsed with VR separation, a pattern not seen in any of the control patients. All patients had IMH closure after vitrectomy and visual results were not significantly different from the control group. CONCLUSIONS: Ocriplasmin facilitates more complete VR separation in patients undergoing surgery for IMH, although it does not result in more eccentric epiretinal tissue release.
Authors: D H W Steel; C Parkes; V T Papastavrou; P J Avery; I A El-Ghrably; M S Habib; M T Sandinha; J Smith; K P Stannard; D Vaideanu-Collins; R J Hillier Journal: Eye (Lond) Date: 2016-03-11 Impact factor: 3.775
Authors: Haifa A Madi; Richard J Haynes; Diana Depla; Morten D de la Cour; Sarit Lesnik-Oberstein; Mahi M K Muqit; Niall Patton; Nick Price; David H W Steel Journal: Graefes Arch Clin Exp Ophthalmol Date: 2016-06-08 Impact factor: 3.117
Authors: Arshad M Khanani; Ryan N Constantine; Koenraad H Blot; Benedicte Lescrauwaet; Peter Szurman Journal: Acta Ophthalmol Date: 2020-12-26 Impact factor: 3.761