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玻璃体内注射纤溶酶治疗玻璃体黄斑牵拉后通过多焦视网膜电图评估的功能改善

Functional improvement assessed by multifocal electroretinogram after Ocriplasmin treatment for vitreomacular traction.

作者信息

Rossi Settimio, Testa Francesco, Melillo Paolo, Orrico Ada, Della Corte Michele, Simonelli Francesca

机构信息

Eye clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, Second University of Naples, Via Sergio Pansini, 5, 80131, Naples, Italy.

出版信息

BMC Ophthalmol. 2016 Jul 18;16:110. doi: 10.1186/s12886-016-0284-3.

Abstract

BACKGROUND

To evaluate the functional recovery of patients with symptomatic vitreomacular traction (VMT) after Ocriplasmin treatment.

METHODS

Prospective, single centre, consecutive case series. Patients were treated with a single intravitreal injection of Ocriplasmin (Jetrea, Thrombogenics Inc, USA, Alcon/Novartis EU). The following outcome measures are considered: resolution of VMT, evaluated through the use of optical coherence tomography (SD-OCT), functional recovery evidenced by multifocal-electroretinogram (mfERG) and microperimetry (MP1) after treatment with Ocriplasmin.

RESULTS

Four eyes of four patients were treated with Ocriplasmin injection. We observed a VMT non-surgical resolution in all patients. The longitudinal statistical analysis showed a significant improvement of best corrected visual acuity (BCVA) in the treated eye of about 0.97 letters/week (p = 0.033). No significant difference was observed in mean sensitivity (p > 0.05) assessed by MP1 in both eyes, while improvement in fixation stability was assessed in treated eyes (β = 0.39; p = 0.029). In the four treated eyes mfERG revealed an increased foveal peak response over the follow-up. The longitudinal analysis of mfERG data shows a significant increase of N1 and P1 amplitude in the first rings and a significant decrease of N1 and P1 implicit time in most rings.

CONCLUSIONS

We report on four cases with resolution of VMT after Ocriplasmin treatment. Our preliminary results demonstrate that Ocriplasmin is safe and effective in the treatment of VMT, because it not only leads to a morphological recovery but mostly to a restoration of macular functionality, evaluated through the use of different objective tests, such as MP1 and mfERG over a six-month follow-up.

摘要

背景

评估症状性玻璃体黄斑牵引(VMT)患者接受奥克纤溶酶治疗后的功能恢复情况。

方法

前瞻性、单中心、连续病例系列研究。患者接受单次玻璃体内注射奥克纤溶酶(Jetrea,美国血栓形成公司,爱尔康/诺华欧盟)。考虑以下结局指标:通过光学相干断层扫描(SD-OCT)评估VMT的消退情况,以及奥克纤溶酶治疗后通过多焦视网膜电图(mfERG)和微视野计(MP1)证明的功能恢复情况。

结果

4例患者的4只眼接受了奥克纤溶酶注射治疗。我们观察到所有患者的VMT均通过非手术方式消退。纵向统计分析显示,治疗眼的最佳矫正视力(BCVA)有显著改善,约为每周0.97个字母(p = 0.033)。双眼通过MP1评估的平均敏感度无显著差异(p > 0.05),而治疗眼的注视稳定性有所改善(β = 0.39;p = 0.029)。在4只治疗眼中,mfERG显示随访期间中央凹峰值反应增加。mfERG数据的纵向分析显示,第一环中N1和P1波幅显著增加,大多数环中N1和P1隐含时间显著减少。

结论

我们报告了4例奥克纤溶酶治疗后VMT消退的病例。我们的初步结果表明,奥克纤溶酶治疗VMT安全有效,因为它不仅能实现形态学恢复,而且在六个月的随访中,通过使用MP1和mfERG等不同客观测试评估,还能实现黄斑功能的恢复。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2baf/4949888/ccdf6b8f978e/12886_2016_284_Fig1_HTML.jpg

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