Reversible vision loss and outer retinal abnormalities after intravitreal ocriplasmin injection

Retin Cases Brief Rep. 2014 Fall;8(4):330-2. doi: 10.1097/ICB.0000000000000061.

Abstract

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.

Publication types

  • Case Reports

MeSH terms

  • Acute Disease
  • Female
  • Fibrinolysin / adverse effects*
  • Fibrinolytic Agents / adverse effects*
  • Humans
  • Intravitreal Injections
  • Middle Aged
  • Peptide Fragments / adverse effects*
  • Remission, Spontaneous
  • Retinal Diseases / chemically induced*
  • Vision Disorders / chemically induced*

Substances

  • Fibrinolytic Agents
  • Peptide Fragments
  • microplasmin
  • Fibrinolysin