Metzger D, Assaf A, Maier M M, Groselli S, Klaas J, Feucht N
Eye Medical Care Center, Landshut, Germany.
Rechts der Isar hospital, Technical University of Munich, Munich, Germany.
Int Ophthalmol. 2025 Jun 12;45(1):239. doi: 10.1007/s10792-025-03591-6.
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).
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).
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%.
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.
报告玻璃体内注射奥克纤溶酶（IVO）与全氟丙烷（PVL）治疗有症状的局灶性玻璃体黄斑牵引（VMTS）伴或不伴全层黄斑裂孔（FTMH＜400μm）患者的疗效和风险情况。
19例VMTS患者接受了0.3ml全氟丙烷注射，68例患者接受了奥克纤溶酶注射。主要成功标准包括玻璃体黄斑牵引（VMT）的消退和FTMH＜400μm的闭合。使用SD OCT评估黄斑裂孔大小、黄斑水肿、视网膜下液、椭圆体带（EZ）和外界膜（ELM）的微观结构变化。
在PVL组中，78.92%的患者VMT消退。PVL治疗后，FTMH＜400μm的患者无一闭合，但随后行玻璃体切割术（ppV）后全部闭合。7.1%的患者出现新的FTMH，5.3%的患者发生孔源性视网膜脱离。31.6%的患者出现EZ/ELM改变。在IVO组中，70.6%的患者VMT消退。在22例FTMH患者中，45.6%在IVO治疗后闭合，25例中有12例需要行ppV。6.5%的患者出现新的FTMH，4.4%的患者发生视网膜脱离。16.2%的患者出现EZ/ELM改变。
PVL和IVO的VMT消退率相似。与IVO相比，PVL在闭合FTMH方面效果较差且副作用较高。在存在视网膜病变的情况下，PVL比IVO更可取。
