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ELLIPSOID ZONE MAPPING AND OUTER RETINAL CHARACTERIZATION AFTER INTRAVITREAL OCRIPLASMIN
1Ophthalmic Imaging Center, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio.
Retina (Philadelphia, Pa.)
|June 25, 2016
Summary
Intravitreal ocriplasmin causes temporary outer retinal changes, specifically reducing ellipsoid zone (EZ) to retinal pigment epithelium (RPE) volume. These EZ alterations typically resolve within three months, though some patients experience persistent symptoms.
Area of Science:
- Ophthalmology
- Retinal Imaging
- Macular Diseases
Background:
- Intravitreal ocriplasmin is used for vitreomacular adhesion.
- Outer retinal integrity is crucial for visual function.
- Assessing structural changes post-treatment is important for patient outcomes.
Purpose of the Study:
- To evaluate outer retinal architectural alterations following intravitreal ocriplasmin.
- To utilize a novel automated ellipsoid zone (EZ) mapping algorithm for quantitative assessment.
- To correlate structural changes with clinical outcomes.
Main Methods:
- Retrospective analysis of spectral-domain optical coherence tomography (SD-OCT) images.
- Quantitative assessment of EZ-RPE central area, macular volume, and en face EZ integrity.
- Longitudinal tracking of EZ changes before and after ocriplasmin injection.
Main Results:
- A significant reduction in EZ-RPE volume was observed at 1 week post-injection (P=0.0036).
- 36.8% of patients reported visual symptoms, associated with subretinal fluid and EZ attenuation.
- EZ-RPE volume and EZ integrity generally recovered by 3 months.
Conclusions:
- Automated EZ mapping is a feasible method for assessing EZ-RPE volume and integrity.
- Ocriplasmin therapy can cause significant, yet typically reversible, outer retinal alterations.
- The observed EZ changes are panretinal and can correlate with subjective patient symptoms.
