Calculating the individual probability of successful ocriplasmin treatment in eyes with VMT syndrome: a multivariable prediction model from the EXPORT study

Br J Ophthalmol. 2018 Aug;102(8):1092-1097. doi: 10.1136/bjophthalmol-2017-310874. Epub 2017 Oct 31.

Abstract

Background/aims: To evaluate predictive factors for the treatment success of ocriplasmin and to use these factors to generate a multivariate model to calculate the individual probability of successful treatment.

Methods: Data were collected in a retrospective, multicentre cohort study. Patients with vitreomacular traction (VMT) syndrome without a full-thickness macular hole were included if they received an intravitreal injection (IVI) of ocriplasmin. Five factors (age, gender, lens status, presence of epiretinal membrane (ERM) formation and horizontal diameter of VMT) were assessed on their association with VMT resolution. A multivariable logistic regression model was employed to further analyse these factors and calculate the individual probability of successful treatment.

Results: 167 eyes of 167 patients were included. Univariate analysis revealed a significant correlation to VMT resolution for all analysed factors: age (years) (OR 0.9208; 95% CI 0.8845 to 0.9586; p<0.0001), gender (male) (OR 0.480; 95% CI 0.241 to 0.957; p=0.0371), lens status (phakic) (OR 2.042; 95% CI 1.054 to 3.958; p=0.0344), ERM formation (present) (OR 0.384; 95% CI 0.179 to 0.821; p=0.0136) and horizontal VMT diameter (µm) (OR 0.99812; 95% CI 0.99684 to 0.99941, p=0.0042). A significant multivariable logistic regression model was established with age and VMT diameter.

Conclusion: Known predictive factors for VMT resolution after ocriplasmin IVI were confirmed in our study. We were able to combine them into a formula, ultimately allowing the calculation of an individual probability of treatment success with ocriplasmin in patients with VMT syndrome without FTHM.

Keywords: diagnostic tests/investigation; macula; retina; treatment medical; vitreous.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cohort Studies
  • Epiretinal Membrane / physiopathology
  • Female
  • Fibrinolysin / therapeutic use*
  • Fibrinolytic Agents / therapeutic use*
  • Humans
  • Intravitreal Injections
  • Male
  • Middle Aged
  • Models, Statistical
  • Peptide Fragments / therapeutic use*
  • Probability
  • Retinal Diseases / diagnosis
  • Retinal Diseases / drug therapy*
  • Retinal Diseases / physiopathology
  • Retrospective Studies
  • Tomography, Optical Coherence
  • Visual Acuity / physiology
  • Vitreous Detachment / diagnosis
  • Vitreous Detachment / drug therapy*
  • Vitreous Detachment / physiopathology

Substances

  • Fibrinolytic Agents
  • Peptide Fragments
  • microplasmin
  • Fibrinolysin