Silva Ruwan A, Moshfeghi Darius M, Leng Theodore
Byers Eye Institute at Stanford, Stanford University School of Medicine, Palo Alto, CA, USA.
Clin Ophthalmol. 2014 Aug 25;8:1591-4. doi: 10.2147/OPTH.S68037. eCollection 2014.
Ocriplasmin represents a new treatment option for numerous vitreoretinopathies involving an abnormal vitreomacular interface. While the drug may circumvent the traditional risks of surgical treatment, pharmacologic vitreolysis is not devoid of risk itself. This report presents two cases, one of vitreomacular traction syndrome and the other of a full-thickness macular hole, both of which were treated with an intravitreal injection of ocriplasmin. Notably, in both cases, vitreomacular traction of the macula appears to have been alleviated; however, failure to completely relieve vitreoretinal traction from the peripheral retina generated retinal breaks with one patient eventually developing a macula-involving retinal detachment. Thus, even in instances of 'successful' pharmacologic treatment of vitreomacular traction, continued follow-up evaluation is essential.
奥克纤溶酶是治疗多种累及异常玻璃体黄斑界面的玻璃体视网膜病变的一种新选择。虽然该药物可能规避手术治疗的传统风险，但药物性玻璃体溶解本身并非没有风险。本报告介绍了两例病例，一例为玻璃体黄斑牵引综合征，另一例为全层黄斑裂孔，均接受了玻璃体内注射奥克纤溶酶治疗。值得注意的是，在这两例病例中，黄斑的玻璃体黄斑牵引似乎均已缓解；然而，由于未能完全解除周边视网膜的玻璃体视网膜牵引，导致一名患者出现视网膜裂孔，最终发展为累及黄斑的视网膜脱离。因此，即使在药物治疗玻璃体黄斑牵引“成功”的情况下，持续的随访评估也是必不可少的。
