Sam Mansour

Transient vision loss after ocriplasmin injection.

Purpose: Transient vision loss is a poorly understood complication of ocriplasmin injection. Methods: The authors performed a retrospective medical records review of consecutive patients who received ocriplasmin for the treatment of vitreomacular adhesion at The George Washington University Department of Ophthalmology and the Virginia Retinal Center from January 1, 2013, to March 1, 2014, and who had at least 28 days of follow-up. Ellipsoid zone loss on optical coherence tomography was analyzed using the National Institutes of Healths Medical Imaging, Processing, Analysis, and Visualization (MIPAV) software. Results: Ten patients received ocriplasmin injection. Three of the 10 patients (30%) had release of vitreomacular adhesion, and 8 of the 10 (80%) experienced vision loss within the first month. Average baseline visual acuity was 66 Early Treatment Diabetic Retinopathy Study letters. Average visual acuity at Weeks 1, 2, 3, and 4 was 62, 43, 57, and 56 Early Treatment Diabetic Retinopathy Study letters, respectively. Average final visual acuity was 58 Early Treatment Diabetic Retinopathy Study letters. Ellipsoid loss occurred in 5 patients and reached a nadir (−36.9% decrease from baseline) 2 weeks later. Conclusion: Vision loss after ocriplasmin occurred in the majority of patients and was correlated with loss of the ellipsoid layer on optical coherence tomography. More data are needed to analyze this side effect.

Acute vision loss after ocriplasmin use.

PURPOSE There have been reports in the literature of transient vision loss after ocriplasmin injection and ellipsoid layer disruption on spectral domain optical coherence tomography. The authors report a patient with transient vision loss and more prolonged ellipsoid layer dysfunction. PATIENT The authors present a 55-year-old woman with vitreomacular traction and a small foveal schisis who received ocriplasmin injection and experienced sudden transient vision loss. Spectral domain optical coherence tomography imaging revealed significantly increased schisis, new subretinal cavity, and prolonged ellipsoid layer disruption at 9 months. DISCUSSION Previous reports suggested that acute vision loss after ocriplasmin injection may be due to ellipsoid layer disruption. This case showed vision loss, which may due to increased foveal schisis and a new subretinal cavity on spectral domain optical coherence tomography imaging. There was little correlation between ellipsoid layer loss and visual function.