Reactions 1501, p30-31 - 17 May 2014

SOcriplasmin

Vision loss in an elderly patient: case reportA 71-year-old woman with symptomatic vitreomacular

traction (VMT) developed vision loss following intravitrealinjection of ocriplasmin [Jetrea].

The woman received an intravitreal injection of ocriplasmin0.125mg/0.1mL. One day later, her visual acuity decreased to20/200. Spectral-domain optical coherence tomographyshowed release of VMT, with near disappearance of the innersegment-outer segment (ellipsoid) layer. Her visual acuitygradually improved to 20/40 over the following months, butshe continued to experience darkening of vision in dimillumination. Multifocal electroretinography (ERG) showed areduction in the foveal peak and surrounding 3 rings of the lefteye. Decreased A- and B-wave amplitudes were seen on full-field ERG. Photopic ERG also showed a reduction of ~30% incone function, with an increased implicit time.

Author comment: "It is possible that this effect of themedication may be due to a diffuse enzymatic effect of theprotease on the photoreceptors or the retinal pigmentepithelium throughout the retina."Tibbetts MD, et al. Vision loss after intravitreal ocriplasmin: Correlation ofspectral-domain optical coherence tomography and electroretinography. JAMAOphthalmology 132: 487-490, No. 4, Apr 2014 - USA 803103101

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Reactions 17 May 2014 No. 15010114-9954/14/1501-0001/$14.95 Adis © 2014 Springer International Publishing AG. All rights reserved