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PERSISTENT RETINAL CHANGES AFTER INTRAVITREAL OCRIPLASMIN.

Jordan A Margo¹, Lisa S Schocket, Karen Klima

¹Department of Ophthalmology and Visual Sciences, University of Maryland, Baltimore, Maryland.

Retinal Cases & Brief Reports

|December 20, 2015

Summary

Intravitreal ocriplasmin injections for macular conditions may cause persistent vision loss. This case report details long-term electroretinographic and optical coherence tomography abnormalities, suggesting potential permanent retinal damage.

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Area of Science:

Ophthalmology
Retinal Diseases
Pharmacovigilance

Background:

Ocriplasmin, administered via intravitreal injection, treats symptomatic vitreomacular adhesion and macular hole.
Clinical trials indicated a favorable safety profile for ocriplasmin.
Postmarket surveillance and case reports suggest potential vision-threatening side effects.

Observation:

A 70-year-old male experienced persistent macular subretinal fluid 10 weeks post-ocriplasmin injection.
Spectral domain optical coherence tomography revealed minimal fluid resolution over 11 months.
Electroretinography showed sustained rod photoreceptor sensitivity loss at 14 months.

Findings:

This report documents the first instance of persistent electroretinographic and optical coherence tomographic abnormalities following ocriplasmin use.

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Proposed mechanism involves fibronectin and laminin cleavage, disrupting the interphotoreceptor matrix.

This disruption leads to ellipsoid layer attenuation, photoreceptor sensitivity loss, and subretinal fluid.

Implications:

Persistent abnormalities suggest ocriplasmin may pose a risk of permanent retinal damage.
Further investigation into ocriplasmin's long-term ocular safety is warranted.
Ophthalmologists should be vigilant for these potential adverse events in patients treated with ocriplasmin.