Abstract
Purpose
To study the efficacy of a single intravitreal injection of expansile gas as a valuable alternative to current treatment options (conservative, pharmacological, and surgical) in patients with symptomatic, focal vitreomacular traction (VMT).
Patients and methods
This study comprises a retrospective, interventional case series of patients. Twenty eyes in seventeen patients with symptomatic and persisting focal VMT were treated in an outpatient setting with an intravitreal gas injection of 0.2 ml. In 19 eyes, 100% hexafluoroethane (C2F6) was used. One eye received sulfur hexafluoride (SF6). To all but three patients posturing advice was given. Patients were reviewed with a full-eye examination and ocular coherence tomography (OCT) after 14 days and later. The primary outcome measure was the release of VMT on OCT.
Results
In 17 of the 20 (85.0%) treated eyes, a release of VMT was achieved as documented on OCT. The release of VMT was diagnosed during the first month after injection in 11 eyes of 11 patients and within 3 months in 16 eyes of 15 patients. In all but five of our patients, best corrected visual acuity (BCVA) remained stable or improved. In four patients, the progression or development of cataract was the probable cause of the decrease in BCVA. One patient developed a stage II macular hole after injection and needed vitrectomy. None of the treated patients developed retinal breaks.
Conclusion
Intravitreal expansile gas injection could offer a minimally invasive, low-cost alternative treatment in patients with symptomatic, persisting VMT. Additional studies on a larger number of patients are required.
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Claus, M., Feron, E. & Veckeneer, M. Pneumatic release of focal vitreomacular traction. Eye 31, 411–416 (2017). https://doi.org/10.1038/eye.2016.231
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DOI: https://doi.org/10.1038/eye.2016.231
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