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Reversible vision loss and outer retinal abnormalities after intravitreal ocriplasmin injection
Aristomenis Thanos1, Jonathan Hernandez-Siman, Kyle V Marra
1*Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts; †The Warren Alpert Medical School, Brown University, Providence, Rhode Island; ‡Retina Service, Division of Ophthalmology, Beth Israel Medical Center, Boston, Massachusetts; and §Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts.
Purpose:
Ocriplasmin is a truncated form of the human serine protease plasmin, which was recently approved for the nonsurgical treatment of symptomatic vitreomacular adhesions. According to its FDA label, approximately 8% of subjects experienced acute transient vision loss during the first week after injection with no alternative explanation for the change. This report focuses on a recent case of recovered vision loss over a 3-month period after the injection.
Methods:
A comprehensive ophthalmic examination was performed before the injection, during the day of the injection, and at 2 days, 2 weeks, 1 month, and 4 months after the injection. This examination included a full ophthalmic workup and imaging with spectral domain optical coherence tomography. A case of a 55-year-old woman who experienced acute severe vision loss 2 days after the treatment with ocriplasmin was reported.
Results:
Distinct alterations, as seen with spectral domain optical coherence tomography, were observed in the ellipsoid zone of photoreceptors. These changes together with patient's visual acuity gradually recovered over a 3-month period after the injection.
Conclusion:
Further investigation may be warranted to fully elucidate the precise molecular mechanisms involved in patients with unexplained vision loss after ocriplasmin injection.
