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Acute panretinal structural and functional abnormalities after intravitreous ocriplasmin injection
Abigail T Fahim1, Naheed W Khan1, Mark W Johnson1
1Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor.
JAMA Ophthalmology
|March 1, 2014
Summary
Ocriplasmin injection for vitreomacular traction may cause widespread retinal dysfunction. This may be due to the drug cleaving intraretinal laminin, affecting the entire retina.
Area of Science:
- Ophthalmology
- Retinal Diseases
- Pharmacology
Background:
- Ocriplasmin is used to treat vitreomacular traction by cleaving vitreous gel components.
- Laminin, a key component, is also present in retinal layers, raising concerns about potential toxicity.
Observation:
- A 63-year-old woman experienced acute panretinal dysfunction after ocriplasmin injection for a macular hole.
- Symptoms included vision loss, visual field constriction, pupillary abnormalities, and retinal artery attenuation.
Findings:
- Spectral-domain optical coherence tomography showed loss of outer retinal signals.
- Electroretinography revealed reduced A- and B-waves, indicating postreceptoral and photoreceptor dysfunction.
Implications:
- Ocriplasmin-induced retinal dysfunction can affect the entire retina, not just the macula.
- Cleavage of intraretinal laminin is a proposed mechanism for ocriplasmin's toxic effects.
