Lenk J, Matthé E, Ventzke S, Pillunat L E, Sandner D
Augenklinik, Universitätsklinikum Carl Gustav Carus, TU Dresden.
Klin Monbl Augenheilkd. 2018 Jan;235(1):73-80. doi: 10.1055/s-0042-124511. Epub 2017 Mar 10.
In vitreomacular traction (VMT), there is abnormal adhesion between the vitreous cortex and the retina, especially in the fovea. Symptoms of VMT include metamorphopsia and a decrease in visual acuity. Since 2013, ocriplasmin (Jetrea®) has been approved for treatment of symptomatic vitreomacular traction with or without macular holes (≤ 400 µm).
We retrospectively examined twenty-three eyes of twenty-one patients who underwent intravitreal ocriplasmin treatment for symptomatic vitreomacular traction with or without macular holes. Best corrected visual acuity and central retinal thickness (CRT) were measured in advance and after ocriplasmin treatment. The numbers of resolved vitreomacular traction and closed macular holes were documented.
Vitreomacular traction was resolved in eight of twenty-three eyes (34.8 %); in fifteen eyes (65.2 %) it was persistent and two of four macular holes were found closed. The average best corrected visual acuity was 0.39 ± 0.25 logMAR at baseline and 0.41 ± 0.24 logMAR at the first follow-up visit after injection (p = 0.613). The average CRT was 453.3 ± 172.7 µm at baseline, with a slight decrease to 412.0 ± 212 µm (p = 0.124).
Intravitreal injection of ocriplasmin appears is an experimental therapy in patients with symptomatic vitreomacular traction. Patient selection seems to be critically important for the therapeutic outcome, whereas greater age, specific VMT morphology and missing chromatopsia seem to be negative predictors.
在玻璃体黄斑牵引（VMT）中，玻璃体皮质与视网膜之间存在异常粘连，尤其是在黄斑区。VMT的症状包括视物变形和视力下降。自2013年以来，奥克纤溶酶（Jetrea®）已被批准用于治疗有或无黄斑裂孔（≤400µm）的症状性玻璃体黄斑牵引。
我们回顾性研究了21例接受玻璃体内注射奥克纤溶酶治疗有或无黄斑裂孔的症状性玻璃体黄斑牵引患者的23只眼。在注射奥克纤溶酶之前和之后测量最佳矫正视力和中心视网膜厚度（CRT）。记录玻璃体黄斑牵引解除和黄斑裂孔闭合的数量。
23只眼中有8只（34.8%）的玻璃体黄斑牵引得到解除；15只眼（65.2%）的牵引持续存在，4个黄斑裂孔中有2个闭合。基线时平均最佳矫正视力为0.39±0.25logMAR，注射后首次随访时为0.41±0.24logMAR（p = 0.613）。基线时平均CRT为453.3±172.7µm，略有下降至412.0±212µm（p = 0.124）。
玻璃体内注射奥克纤溶酶似乎是治疗症状性玻璃体黄斑牵引患者的一种实验性疗法。患者选择对于治疗结果似乎至关重要，而年龄较大、特定的VMT形态和无色觉似乎是负面预测因素。
