Ocriplasmin use in a selected case with preserved visual acuity

Settimio Rossi, Ada Orrico, Paolo Melillo, Francesco Testa, Francesca Simonelli, Michele Della Corte

Previous studies described cases of Ocriplasmin injections in patients with vitreo-macular traction and reduced central visual acuity. We describe the first case of a patient with 20/20 visual acuity and vitreo-macular traction treated with Ocriplasmin, and, for the first time in literature, we evaluated the functional changes of the macula in response to pharmacological treatment through multifocal-electroretinogram. We report the case of a female Caucasian patient aged 67 years with vitreo-macular traction in the right eye, treated with Ocriplasmin, at the Eye Clinic of the Second University of Naples. Visual acuity was 20/20 before treatment, associated with metamorphopsia. Two weeks after injection, optical coherence tomography showed the release of vitreo-macular traction and multifocal electroretinogram responses showed a significant increase of retinal density responses in all six rings (p < 0.03). Visual acuity remained constant with resolution of symptoms and the appearance of vitreous floaters. Intravitreal injection of Ocriplasmin resulted to be a safe and effective treatment in the case here reported. Our data show that the anatomical recovery with release of vitreo-macular traction was associated with a full functional recovery. In fact, the electrical retinal density response of the macular area improved two weeks after Ocriplasmin injection. Further studies with broader inclusion criteria for Ocriplasmin treatment (e.g. also with visual acuity higher than 20/25) on a larger study sample are needed to confirm our results.