Risk factors and efficacy of different intravitreal treatment options for symptomatic focal vitreomacular traction with or without full-thickness macular hole.

PURPOSE

To report the efficacy and risk profile of intravitreal injections of Ocriplasmin (IVO) versus Perfluoropropane (PVL) in patients with symptomatic focal vitreomacular traction (VMTS) with or without full-thickness macular hole (FTMH < 400 μm).

METHODS

Nineteen patients with VMTS received 0.3 ml perfluoropropane, and 68 patients received Ocriplasmin. Primary success criteria included resolution of vitreomacular traction (VMT) and closure of FTMH < 400 μm. Microstructural changes were evaluated using SD OCT for macular hole size, macular edema, subretinal fluid, ellipsoid zone (EZ), and external limiting membrane (ELM).

RESULTS

In the PVL group, 78.92% experienced VMT resolution. None of the FTMH < 400 μm closed with PVL, but all were closed with subsequent pars plana vitrectomy (ppV). New FTMH developed in 7.1% and rhegmatogenous retinal detachment in 5.3%. EZ/ELM changes occurred in 31.6%. In the IVO group, 70.6% achieved VMT resolution. Of 22 patients with FTMH, 45.6% had closure after IVO, with 12 out of 25 needing ppV. New FTMH occurred in 6.5% and retinal detachment in 4.4%. EZ/ELM changes were observed in 16.2%.

CONCLUSION

Both PVL and IVO showed similar VMT resolution rates. PVL was less effective in closing FTMH and had higher side effects compared to IVO. In the presence of retinal pathologies, PVL is preferable to IVO.