Long-Term Persistence of Subfoveal Fluid Following Ocriplasmin-Treatment of an FTMH

Introduction

Ocriplasmin is a recombinant human serine protease that, applied intravitreally, affects proteins, such as laminin and fibronectin, of the interface between the posterior vitreous and the internal limiting membrane to resolve the adhesion [1].

The intravitreal injection of Ocriplasmin for treating symptomatic vitreomacular adhesion (sVMA) was approved for the European Union in the year 2013. The approval was based on the MIVI-TRUST trials, two phase III randomized international placebo-control double-blind studies [2]. These trials showed not just promising treatment of vitreomacular traction (VMT) but also a significant benefit in treating full thickness macular holes (FTMH) with vitreomacular adhesion. Besides treatment of VMT Ocriplasmin was approved for treating small (≤ 250 µm) and medium (≤ 400 µm) FTMH. The studies showed that nonsurgical closure of a macular hole by day 28 was achieved in 40.6 % through the injection of Ocriplasmin [2].

Disintegration of the photoreceptor-RPE contact and new occurring deposition of transient subfoveal fluid is a common side effect after Ocriplasmin use. The fluid usually resorbs spontaneously, generally without permanent structural or functional damage, but persistent retinal changes have been reported [3], [4], [5], [6]. We report a case of unusual postoperative extension and long-term persistence of subfoveal fluid following successful resolution of VMT and successful closure of a FTMH after Ocriplasmin.

• References

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