Reiss Benjamin, Smithen Lindsay, Mansour Sam
Department of Ophthalmology, The George Washington University, Washington, District of Columbia.
Retina. 2015 Jun;35(6):1107-10. doi: 10.1097/IAE.0000000000000542.
Transient vision loss is a poorly understood complication of ocriplasmin injection.
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 Health's Medical Imaging, Processing, Analysis, and Visualization (MIPAV) software.
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.
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.
短暂性视力丧失是玻璃体内注射奥克纤溶酶一种了解甚少的并发症。
作者对2013年1月1日至2014年3月1日在乔治华盛顿大学眼科和弗吉尼亚视网膜中心接受奥克纤溶酶治疗玻璃体黄斑粘连且至少随访28天的连续患者进行了回顾性病历审查。使用美国国立卫生研究院的医学成像、处理、分析和可视化（MIPAV）软件分析光学相干断层扫描上的椭圆体带损失情况。
10例患者接受了奥克纤溶酶注射。10例患者中有3例（30%）发生了玻璃体黄斑粘连松解，10例中有8例（80%）在第一个月内出现视力丧失。平均基线视力为66个早期糖尿病视网膜病变研究字母。第1、2、3和4周时的平均视力分别为62、43、57和56个早期糖尿病视网膜病变研究字母。平均最终视力为58个早期糖尿病视网膜病变研究字母。5例患者出现椭圆体带损失，2周后降至最低点（比基线下降36.9%）。
大多数患者在注射奥克纤溶酶后出现视力丧失，且与光学相干断层扫描上椭圆体层的损失相关。需要更多数据来分析这种副作用。
