Full-Thickness Macular Hole and Symptomatic Vitreomacular Adhesion: Comparison of Visual Results in Patients Receiving Pars Plana Vitrectomy in One Eye and Ocriplasmin in the Fellow Eye

Abstract

Purpose: This article compares bilateral visual outcomes in patients receiving a vitrectomy in one eye for a full-thickness macular hole (FTMH) who also received ocriplasmin treatment in the fellow eye for symptomatic vitreomacular adhesion (VMA). Methods: This was a multicenter, retrospective study to assess the difference in best-corrected visual acuity (BCVA) in patients receiving a vitrectomy in the eye with an FTMH and ocriplasmin treatment for the fellow eye with symptomatic VMA but no FTMH. Patients initially received either a single injection of ocriplasmin 0.125 mg for symptomatic VMA or a vitrectomy for FTMH. After the first eye was stable following the initial treatment option, the second eye was treated with the opposite modality. BCVA was measured at baseline, month 3, and month 6, with up to 2 years of additional follow-up. Results: Thirty-six eyes (18 patients) were included in the analysis. Eyes that underwent a vitrectomy for FTMH had a mean baseline BCVA of 20/123 and a final BCVA of 20/53. Eyes receiving ocriplasmin treatment for VMA had a mean baseline BCVA of 20/49 and a final BCVA of 20/33. The median time between the 2 treatments was 5.5 months. Eyes receiving ocriplasmin had a median time to VMA resolution of 4 weeks. Conclusions: Treatment with ocriplasmin showed successful resolution of VMA and improvement in BCVA, obviating the need for vitrectomy. The current study provides a framework for the treatment of patients with a current FTMH in one eye and VMA without an FTMH in the contralateral eye.