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葡萄牙在临床实践中使用奥克纤溶酶的经验。

The Portuguese Experience with Ocriplasmin in Clinical Practice.

作者信息

Figueira João, Martins David, Pessoa Bernardete, Ferreira Natália, Meireles Angelina, Sampaio António, Carneiro Ângela, Vaz Fernanda, Nascimento João, Moreno Natacha, Roque José, Domingues Manuel, Flores Rita, Teixeira Carla, Conde Eduardo, Henriques Filipe, Proença Helena, Pita Negrão José, Barbosa Marisa, Silva Rufino, Vaz-Pereira Sara, Pereira Neves Pedro, Gomes Nuno, Raimundo Miguel

机构信息

Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.

出版信息

Ophthalmic Res. 2016;56(4):186-192. doi: 10.1159/000446842. Epub 2016 Jul 20.

Abstract

AIM

Evaluate the real-life experience with ocriplasmin on vitreomacular traction (VMT) release and full-thickness macular hole (FTMH) closure in Portugal.

METHODS

Multicentric, retrospective study of 83 eyes of 78 patients who were treated with intravitreal ocriplasmin for VMT with and without FTMH. Primary outcomes were VMT release and FTMH closure. Secondary outcomes included visual acuity changes and structural features on spectral-domain ocular coherence tomography.

RESULTS

VMT resolved in 47 of the 83 eyes (56.6%) and 6 of the 12 FTMH were closed (50.0%). Mean best-corrected visual acuity (BCVA) improved from 65.1 at baseline to 70.8 ETDRS letters at the end of follow-up (p < 0.0001) with a mean follow-up of 138.8 days. Improvement in BCVA was significantly better in eyes with VMT release (p = 0.021). Approximately 73% of patients had normal ellipsoid zone integrity at the end of follow-up, 87% had no neurosensorial detachment and 40% had no intra- or subretinal fluid.

CONCLUSION

VMT release and FTMH closure were achieved in more than half of the treated eyes and were correlated with significant BCVA improvements and favorable baseline characteristics. In fact, if a careful patient selection is carried out, VMT resolution with ocriplasmin can be optimized, tailoring the best approach to each patient.

摘要

目的

评估在葡萄牙使用奥克纤溶酶治疗玻璃体黄斑牵引(VMT)松解和全层黄斑裂孔(FTMH)闭合的实际临床经验。

方法

对78例接受玻璃体内注射奥克纤溶酶治疗VMT(伴或不伴FTMH)的患者的83只眼进行多中心回顾性研究。主要结局为VMT松解和FTMH闭合。次要结局包括视力变化以及频域光学相干断层扫描的结构特征。

结果

83只眼中有47只(56.6%)的VMT得到缓解,12例FTMH中有6例(50.0%)闭合。平均最佳矫正视力(BCVA)从基线时的65.1提高到随访结束时的70.8 ETDRS字母(p < 0.0001),平均随访时间为138.8天。VMT松解的眼中BCVA改善明显更好(p = 0.021)。随访结束时,约73%的患者椭圆体带完整性正常,87%的患者无神经感觉层脱离,40%的患者无视网膜内或视网膜下液。

结论

超过半数的治疗眼实现了VMT松解和FTMH闭合,且与BCVA显著改善及良好的基线特征相关。事实上,如果进行仔细的患者选择,使用奥克纤溶酶解决VMT的效果可以得到优化,为每位患者量身定制最佳治疗方法。

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