Rhegmatogenous retinal detachment following intravitreal ocriplasmin

• Published in: Graefe's archive for clinical and experimental ophthalmology 2016-12, Vol.254 (12), p.2333-2338
• Main Authors: Madi, Haifa A., Haynes, Richard J., Depla, Diana, de la Cour, Morten D., Lesnik-Oberstein, Sarit, Muqit, Mahi M. K., Patton, Niall, Price, Nick, Steel, David H.W.
• Format: Article
• Language: English
• Subjects: Aged; Female; Fibrinolysin - administration & dosage; Fibrinolysin - adverse effects; Follow-Up Studies; Humans; Intravitreal Injections; Male; Medicine; Medicine & Public Health; Middle Aged; Ophthalmology; Peptide Fragments - administration & dosage; Peptide Fragments - adverse effects; Prognosis; Retina - drug effects; Retina - pathology; Retinal Detachment - chemically induced; Retinal Detachment - diagnosis; Retinal Disorders; Retinal Perforations - diagnosis; Retinal Perforations - drug therapy; Retrospective Studies; Tomography, Optical Coherence - methods; Visual Acuity; Vitreous Detachment - diagnosis; Vitreous Detachment - drug therapy
• ISSN: 0721-832X; 1435-702X
• DOI: 10.1007/s00417-016-3398-7

Purpose To describe the characteristics and outcomes of patients presenting with rhegmatogenous retinal detachment (RRD) after ocriplasmin (OCP) injection. Methods Retrospective, multi-centre, observational case series with case note review. Results Eight patients with symptomatic vitreomacular traction (six with concomitant macular hole) were diagnosed with RRD after a median of 16 days (range 3–131 days) post-OCP injection. Presentation was within 3 weeks of the OCP injection in six of the cases. Five patients presented with symptoms post-OCP, and three were diagnosed asymptomatically on planned visits. Seven cases were phakic, one had high myopia (>8 dioptres), and two cases had lattice degeneration. Following RRD surgery, hole closure was achieved in 5/6 MH cases. The final median BCVA at 7 months was 20/80 (range 20/40–20/1200) similar to the baseline BCVA 20/80, with four patients gaining ≥1 line of vision compared to baseline but three losing ≥3 lines. Conclusions RRD is a non-negligible risk associated with intravitreal OCP, and it should be used with caution in eyes with high myopia and peripheral retinal pathology predisposing to RRD. Detailed peripheral retinal examination is recommended pre- and postoperatively at all visits. Patients should be advised to seek attention if symptoms recur after initial presentation.