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Reopening of a Full-Thickness Macular Hole 2 Years After Pharmacologic Closure With Ocriplasmin

Mohammed Ali Khan, MD1; Abtin Shahlaee, MD1; Allen C. Ho, MD1
[+] Author Affiliations
1Retina Service, Wills Eye Hospital, Mid Atlantic Retina, Philadelphia, Pennsylvania
JAMA Ophthalmol. 2015;133(11):1362-1364. doi:10.1001/jamaophthalmol.2015.3331.
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This case report describes the reopening of a macular hole following prior closure with ocriplasmin.

Data from the phase 3 Microplasmin for Intravitreous Injection–Traction Release Without Surgical Treatment (MIVI-TRUST) studies described nonsurgical achievement of macular hole closure as a secondary outcome in 106 patients treated with a single injection of ocriplasmin compared with vehicle injection (40.6% vs 10.6%; P < .001).1 As options for macular hole treatment have expanded with pharmacologic vitreolysis, ongoing monitoring of these patients is prudent and important to further refine risk/benefit profiles.

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Figure 1.
Pharmacologic Release of Vitreomacular Adhesion and Closure of Macular Hole With Ocriplasmin

A and B, Fundus photography (A) and spectral-domain optical coherence tomography (B) confirmed a small full-thickness macular hole. C, Spectral-domain optical coherence tomography also showed a focal vitreomacular adhesion (arrowhead). D, Spectral-domain optical coherence tomography showed that pharmacologic closure of the macular hole was achieved with ocriplasmin (125 µg/0.10 mL), with stable hole closure at 1 year following injection.

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Figure 2.
Reopening of the Macular Hole 2 Years After Prior Closure With Ocriplasmin

A and B, Two years following treatment with ocriplasmin, fundus photography (A) and spectral-domain optical coherence tomography (B) confirmed presence of an epiretinal membrane (arrowhead in B) and reopening of the full-thickness macular hole. C, Surgical hole closure was achieved without complication.

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