UNILATERAL TRANSIENT VISION LOSS FOLLOWING BILATERAL INTRAVITREAL OCRIPLASMIN – CASE REPORT WITH TWO YEARS FOLLOW UP

Detalhes bibliográficos
Autor(a) principal: Proença, Helena
Data de Publicação: 2020
Outros Autores: Pinto, Filomena, Campos, Fátima, Vaz-Pereira, Sara
Tipo de documento: Relatório
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://doi.org/10.48560/rspo.20166
Resumo: Abstract Background: Ocriplasmin is a serine protease approved for the treatment of symptomatic vitreomacular traction (VMT). Post-marketing experience has revealed safety concerns. Materials and Methods: Retrospective case report. Clinical and surgical data were analyzed.  Results: We report a case of intraindividual response to bilateral ocriplasmin injection in a 70 year-old female patient with symptomatic vitreomacular traction syndrome. A single surgeon injected the same patient twice, two years appart, following the same protocol. In the first eye we observed the commonest side effects and no VMT release while in the second eye we documented the rarer and severe ocriplasmin’s adverse events nevertheless with successful VMT release. Conclusions: Ocriplasmin’s severe adverse events are unpredictable and underreported. The noticeable difference in adverse events is not accounted by patient, surgeon or tecnique’s variability. This case raises the question of whether the degree of enzymatic cleavage necessary for drug efficacy and VMT release may coexist with more retinal toxicity.
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spelling UNILATERAL TRANSIENT VISION LOSS FOLLOWING BILATERAL INTRAVITREAL OCRIPLASMIN – CASE REPORT WITH TWO YEARS FOLLOW UPComunicações Curtas e Imagens em OftalmologiaAbstract Background: Ocriplasmin is a serine protease approved for the treatment of symptomatic vitreomacular traction (VMT). Post-marketing experience has revealed safety concerns. Materials and Methods: Retrospective case report. Clinical and surgical data were analyzed.  Results: We report a case of intraindividual response to bilateral ocriplasmin injection in a 70 year-old female patient with symptomatic vitreomacular traction syndrome. A single surgeon injected the same patient twice, two years appart, following the same protocol. In the first eye we observed the commonest side effects and no VMT release while in the second eye we documented the rarer and severe ocriplasmin’s adverse events nevertheless with successful VMT release. Conclusions: Ocriplasmin’s severe adverse events are unpredictable and underreported. The noticeable difference in adverse events is not accounted by patient, surgeon or tecnique’s variability. This case raises the question of whether the degree of enzymatic cleavage necessary for drug efficacy and VMT release may coexist with more retinal toxicity.Introdução: A ocriplasmina é uma enzima proteolítica aprovada para o tratamento da tração vítreo-macular (TVM) sintomática. Após comercialização têm sido relatados alguns efeitos adversos raros mas graves. Materiais e Métodos: Caso clínico retrospetivo. Análise dos registos clínicos e cirúrgicos. Resultados: Relato de caso de injeção bilateral de ocriplasmina numa doente do sexo feminino de 70 anos com TVM sintomática. Um único cirurgião efetuou o procedimento, seguindo igual protocolo, no mesmo doente, com intervalo de dois anos. No primeiro olho não foram registados eventos adversos relevantes, tendo a TVM persistido. Todavia, no olho adelfo, foi documentado um dos efeitos adversos raros mas graves da ocriplasmina: diminuição da acuidade visual marcada para vultos no primerio dia pós-injeção e alterações nos exames tomográfico e electrofisiológicos, não obstante a libertação da TVM. Conclusões: Os efeitos adversos graves da ocriplasmina são imprevisíveis e estão subreportados. A ocorrência de efeitos adversos diferentes não pode, neste caso, ser explicada por variabilidade do doente, da técnica ou do cirurgião. Este caso levanta a questão da existência de eventual relação entre o grau de clivagem enzimática necessária para a eficácia do fármaco e maior toxidade.Ajnet2020-10-24T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/reporthttps://doi.org/10.48560/rspo.20166eng1646-69501646-6950Proença, HelenaPinto, FilomenaCampos, FátimaVaz-Pereira, Sarainfo:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2022-09-22T17:06:12Zoai:ojs.revistas.rcaap.pt:article/20166Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:01:44.611180Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv UNILATERAL TRANSIENT VISION LOSS FOLLOWING BILATERAL INTRAVITREAL OCRIPLASMIN – CASE REPORT WITH TWO YEARS FOLLOW UP
title UNILATERAL TRANSIENT VISION LOSS FOLLOWING BILATERAL INTRAVITREAL OCRIPLASMIN – CASE REPORT WITH TWO YEARS FOLLOW UP
spellingShingle UNILATERAL TRANSIENT VISION LOSS FOLLOWING BILATERAL INTRAVITREAL OCRIPLASMIN – CASE REPORT WITH TWO YEARS FOLLOW UP
Proença, Helena
Comunicações Curtas e Imagens em Oftalmologia
title_short UNILATERAL TRANSIENT VISION LOSS FOLLOWING BILATERAL INTRAVITREAL OCRIPLASMIN – CASE REPORT WITH TWO YEARS FOLLOW UP
title_full UNILATERAL TRANSIENT VISION LOSS FOLLOWING BILATERAL INTRAVITREAL OCRIPLASMIN – CASE REPORT WITH TWO YEARS FOLLOW UP
title_fullStr UNILATERAL TRANSIENT VISION LOSS FOLLOWING BILATERAL INTRAVITREAL OCRIPLASMIN – CASE REPORT WITH TWO YEARS FOLLOW UP
title_full_unstemmed UNILATERAL TRANSIENT VISION LOSS FOLLOWING BILATERAL INTRAVITREAL OCRIPLASMIN – CASE REPORT WITH TWO YEARS FOLLOW UP
title_sort UNILATERAL TRANSIENT VISION LOSS FOLLOWING BILATERAL INTRAVITREAL OCRIPLASMIN – CASE REPORT WITH TWO YEARS FOLLOW UP
author Proença, Helena
author_facet Proença, Helena
Pinto, Filomena
Campos, Fátima
Vaz-Pereira, Sara
author_role author
author2 Pinto, Filomena
Campos, Fátima
Vaz-Pereira, Sara
author2_role author
author
author
dc.contributor.author.fl_str_mv Proença, Helena
Pinto, Filomena
Campos, Fátima
Vaz-Pereira, Sara
dc.subject.por.fl_str_mv Comunicações Curtas e Imagens em Oftalmologia
topic Comunicações Curtas e Imagens em Oftalmologia
description Abstract Background: Ocriplasmin is a serine protease approved for the treatment of symptomatic vitreomacular traction (VMT). Post-marketing experience has revealed safety concerns. Materials and Methods: Retrospective case report. Clinical and surgical data were analyzed.  Results: We report a case of intraindividual response to bilateral ocriplasmin injection in a 70 year-old female patient with symptomatic vitreomacular traction syndrome. A single surgeon injected the same patient twice, two years appart, following the same protocol. In the first eye we observed the commonest side effects and no VMT release while in the second eye we documented the rarer and severe ocriplasmin’s adverse events nevertheless with successful VMT release. Conclusions: Ocriplasmin’s severe adverse events are unpredictable and underreported. The noticeable difference in adverse events is not accounted by patient, surgeon or tecnique’s variability. This case raises the question of whether the degree of enzymatic cleavage necessary for drug efficacy and VMT release may coexist with more retinal toxicity.
publishDate 2020
dc.date.none.fl_str_mv 2020-10-24T00:00:00Z
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