scholarly journals Prognostic Factors Associated with Ocriplasmin Efficacy for the Treatment of Symptomatic Vitreomacular Adhesion and Full-thickness Macular Hole: Analysis from Four Studies

2021 ◽  
Author(s):  
Brian C. Joondeph ◽  
Paul Willems ◽  
Thomas Raber ◽  
Luc Duchateau ◽  
Joseph Markoff
Keyword(s):  
Prognostic Factors ◽  
Macular Hole ◽  
Full Thickness ◽  
Vitreomacular Adhesion ◽  
Phase 3 ◽  
Factors Associated ◽  
Full Thickness Macular Hole ◽  
Baseline Characteristics

Purpose: To assess the effect of patient baseline characteristics on the efficacy of ocriplasmin treatment for symptomatic vitreomacular adhesion (VMA) with full-thickness macular hole (FTMH) from phase 3/4 studies. Methods: Patients with symptomatic VMA and FTMH at baseline and receiving ocriplasmin treatment 125

Full-Thickness Macular Hole and Symptomatic Vitreomacular Adhesion: Comparison of Visual Results in Patients Receiving Pars Plana Vitrectomy in One Eye and Ocriplasmin in the Fellow Eye

2019 ◽  
Vol 3 (5) ◽  
pp. 332-340
Author(s):  
Arshad M. Khanani ◽  
Greggory M. Gahn ◽  
Joseph Markoff ◽  
Hamzah Khalaf ◽  
Victor H. Gonzalez ◽  
...  
Keyword(s):  
Macular Hole ◽  
Median Time ◽  
Full Thickness ◽  
Vitreomacular Adhesion ◽  
Fellow Eye ◽  
Full Thickness Macular Hole ◽  
Successful Resolution ◽  
Pars Plana ◽  
The Difference ◽  
Contralateral Eye

Purpose: This article compares bilateral visual outcomes in patients receiving a vitrectomy in one eye for a full-thickness macular hole (FTMH) who also received ocriplasmin treatment in the fellow eye for symptomatic vitreomacular adhesion (VMA). Methods: This was a multicenter, retrospective study to assess the difference in best-corrected visual acuity (BCVA) in patients receiving a vitrectomy in the eye with an FTMH and ocriplasmin treatment for the fellow eye with symptomatic VMA but no FTMH. Patients initially received either a single injection of ocriplasmin 0.125 mg for symptomatic VMA or a vitrectomy for FTMH. After the first eye was stable following the initial treatment option, the second eye was treated with the opposite modality. BCVA was measured at baseline, month 3, and month 6, with up to 2 years of additional follow-up. Results: Thirty-six eyes (18 patients) were included in the analysis. Eyes that underwent a vitrectomy for FTMH had a mean baseline BCVA of 20/123 and a final BCVA of 20/53. Eyes receiving ocriplasmin treatment for VMA had a mean baseline BCVA of 20/49 and a final BCVA of 20/33. The median time between the 2 treatments was 5.5 months. Eyes receiving ocriplasmin had a median time to VMA resolution of 4 weeks. Conclusions: Treatment with ocriplasmin showed successful resolution of VMA and improvement in BCVA, obviating the need for vitrectomy. The current study provides a framework for the treatment of patients with a current FTMH in one eye and VMA without an FTMH in the contralateral eye.

scholarly journals Cost–effectiveness analysis of ocriplasmin versus watchful waiting for treatment of symptomatic vitreomacular adhesion in the US

2020 ◽  
Vol 9 (4) ◽  
pp. 287-305 ◽  
Author(s):  
Arshad M Khanani ◽  
Pravin U Dugel ◽  
Julia A Haller ◽  
Alan L Wagner ◽  
Benedicte Lescrauwaet ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Macular Hole ◽  
Cost Effective ◽  
Standard Of Care ◽  
Quality Adjusted Life Year ◽  
Phase Iii ◽  
Full Thickness ◽  
Vitreomacular Adhesion ◽  
Health States ◽  
Full Thickness Macular Hole

Aim: Evaluate the cost–effectiveness of ocriplasmin in symptomatic vitreomacular adhesion (VMA) with or without full-thickness macular hole ≤400 μm versus standard of care. Methods: A state-transition model simulated a cohort through disease health states; assignment of utilities to health states reflected the distribution of visual acuity. Efficacy of ocriplasmin was derived from logistic regression models using Ocriplasmin for Treatment for Symptomatic Vitreomacular Adhesion Including Macular Hole trial data. Model inputs were extracted from Phase III trials and published literature. The analysis was conducted from a US Medicare perspective. Results: Lifetime incremental cost–effectiveness ratio was US$4887 per quality-adjusted life year gained in the total population, US$4255 and US$10,167 in VMA subgroups without and with full-thickness macular hole, respectively. Conclusion: Ocriplasmin was cost effective compared with standard of care in symptomatic VMA.

scholarly journals Changes in each retinal layer and ellipsoid zone recovery after full-thickness macular hole surgery

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Min-Woo Lee ◽  
Tae-Yeon Kim ◽  
Yong-Yeon Song ◽  
Seung-Kook Baek ◽  
Young-Hoon Lee
Keyword(s):  
Macular Hole ◽  
Axial Length ◽  
Outer Nuclear Layer ◽  
Plexiform Layer ◽  
Retinal Layer ◽  
Inner Plexiform Layer ◽  
Full Thickness ◽  
Ellipsoid Zone ◽  
Full Thickness Macular Hole ◽  
Fellow Eyes

AbstractTo analyze the changes in each retinal layer and the recovery of the ellipsoid zone (EZ) after full-thickness macular hole (FTMH) surgery. Patients who underwent surgery for FTMH were included. Spectral-domain optical coherence tomography (SD-OCT) was performed preoperatively and postoperatively at 1, 3, 6, 9, and 12 months. A total of 32 eyes were enrolled. Ganglion cell layer, inner plexiform layer, and inner nuclear layer showed significant reductions over time after surgery (P = 0.020, P = 0.001, and P = 0.001, respectively), but were significantly thicker than those of fellow eyes at 12 months postoperatively. The average recovery duration of the external limiting membrane (ELM), outer nuclear layer (ONL), and EZ was 1.5, 2.1, and 6.1 months, respectively. Baseline best-corrected visual acuity (BCVA) (P = 0.003), minimum linear diameter (MLD) (P = 0.025), recovery of EZ (P = 0.008), and IRL thickness (P < 0.001) were significant factors associated with changes in the BCVA. Additionally, axial length (P < 0.001), MLD (P = 0.020), and IRL thickness (P = 0.001) showed significant results associated with EZ recovery. The IRL gradually became thinner after FTMH surgery but was still thicker than that of the fellow eye at 12 months postoperatively. The recovery of ELM and ONL may be a prerequisite for the EZ recovery. The BCVA change was affected by baseline BCVA, MLD, recovery of EZ, and IRL thickness. Additionally, axial length, MLD, and IRL thickness were significantly associated with EZ recovery.

scholarly journals Development of Stage 4 Macular Hole after Spontaneous Closure in a Patient with Stage 2 Macular Hole and a Lamellar Macular Hole-Associated Epiretinal Proliferation

2021 ◽  
pp. 481-484
Author(s):  
Masahisa Watanabe ◽  
Harumasa Yokota ◽  
Hiroshi Aso ◽  
Hirotsugu Hanazaki ◽  
Junya Hanaguri ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Hole ◽  
Spontaneous Closure ◽  
Surgical Removal ◽  
Lamellar Macular Hole ◽  
Full Thickness ◽  
Stage 4 ◽  
Full Thickness Macular Hole ◽  
The Right ◽  
Hole Closure

Herein, we report the longitudinal observation of a case with reopening of the macular hole associated with a lamellar macular hole-associated epiretinal proliferation (LHEP) followed by spontaneous closure in patients with stage 2 idiopathic macular hole. A 64-year-old woman was referred for the decreased visual acuity (VA) and acute anorthopia in the right eye. Funduscopy and optical coherence tomography (OCT) showed stage 2 full-thickness macular hole without posterior vitreous detachment (PVD) and operculum formation. Her best-corrected visual acuity (BCVA) was 20/32. One month later, the diameter of the macular hole was getting small and VA improved. Six months later, the macular hole was treated spontaneously with the attached hyaloid membrane to the macula by OCT and the BCVA improved to 20/20. Fourteen months after the first visit, the BCVA decreased to 20/50 and the patient was diagnosed with stage 4 macular hole with complete PVD. OCT showed full-thickness macular hole with a LHEP in the right eye. After 25G-gauge vitrectomy with the peeling of internal limiting membrane (ILM) and LHEP, the macular hole was closed and BCVA finally improved to 20/25. Spontaneous macular hole closure without PVD may rarely occur in patients with LHEP. The surgical removal of ILM and LHEP may contribute to the successful macular hole closure after vitrectomy.

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