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Clinical science
Calculating the individual probability of successful ocriplasmin treatment in eyes with VMT syndrome: a multivariable prediction model from the EXPORT study
  1. Christoph Paul1,
  2. Christine Heun1,
  3. Hans-Helge Müller2,
  4. Hans Hoerauf3,
  5. Nicolas Feltgen3,
  6. Joachim Wachtlin4,
  7. Hakan Kaymak5,
  8. Stefan Mennel6,
  9. Michael Janusz Koss7,8,
  10. Sascha Fauser9,
  11. Mathias M Maier10,
  12. Ricarda G Schumann11,
  13. Simone Mueller12,
  14. Petrus Chang12,
  15. Steffen Schmitz-Valckenberg12,
  16. Sara Kazerounian13,
  17. Peter Szurman13,
  18. Albrecht Lommatzsch14,
  19. Thomas Bertelmann3,15
  1. 1 Department of Ophthalmology, Philipps-University Marburg, Marburg, Germany
  2. 2 Institute of Medical Biometry and Epidemiology, Philipps-University Marburg, Marburg, Germany
  3. 3 Department of Ophthalmology, University Medical Center Goettingen, Göttingen, Germany
  4. 4 Department of Ophthalmology, Sankt Gertrauden-Krankenhaus, Berlin, Germany
  5. 5 Augenheilkunde, Innovative Internationale Augenchirurgie (IIO), Düsseldorf, Germany
  6. 6 Department of Ophthalmology, Feldkirch State Hospital, Feldkirch, Austria
  7. 7 Department of Ophthalmology, Heidelberg University, Heidelberg, Germany
  8. 8 Augenzentrum Nymphenburger Höfe, Augenklinik Herzog Carl Theodor, Munich, Germany
  9. 9 Department of Ophthalmology, University of Cologne, Cologne, Germany
  10. 10 Department of Ophthalmology, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
  11. 11 Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany
  12. 12 Department of Ophthalmology, University Bonn, Bonn, Germany
  13. 13 Department of Ophthalmology, Knappschaftskrankenhaus Sulzbach, Sulzbach, Germany
  14. 14 Department of Ophthalmology, St Franziskus Hospital, Muenster, Germany
  15. 15 Augenheilkunde, Artemis Eye Clinic, Dillenburg, Germany
  1. Correspondence to Dr Christoph Paul, Department of Ophthalmology, Philipps-University Marburg, Baldingerstraße, Marburg 35043, Germany; paulc{at}staff.uni-marburg.de

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.

  • diagnostic tests/investigation
  • macula
  • retina
  • treatment medical
  • vitreous

https://doi.org/10.1136/bjophthalmol-2017-310874

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    Footnotes

    • Contributors CP analysed and interpreted the data, wrote, proofed and revised the article. H-HM performed the statistical analysis. All the authors have contributed substantially to conception and design, acquisition of data and interpretation of data; revising it critically for important intellectual content and final approval of the version to be published.

    • Competing interests HH reports personal fees from Allergan, personal fees from Alcon, personal fees from Bayer, personal fees from Heidelberg Engineering, personal fees from Novartis, personal fees from Alimera, outside the submitted work; NF reports personal fees and non-financial support from Allergan, personal fees and non-financial support from Bayer, personal fees from Heidelberg Engineering, personal fees and non-financial support from Novartis, personal fees and non-financial support from Alimera, outside the submitted work; JW reports personal fees from Allergan, personal fees from Bayer, personal fees from Novartis, personal fees from Alcon, outside the submitted work; HK reports personal fees from Abbott Medical Optics, personal fees from Alimera Sciences, personal fees from Alcon, personal fees from Allergan, personal fees from Carl Zeiss Meditec AG, personal fees from Dres. Schlegel + Schmidt, personal fees from Ellex, personal fees from Geuder, personal fees from Novartis, personal fees from Oculentis, personal fees from Oertli Instrumente AG, personal fees from Polytech Domilens, personal fees from Topcon Medical, outside the submitted work; SM reports personal fees from Bayer healthcare, personal fees from Novartis, outside the submitted work; MJK reports personal fees from Allergan, personal fees from Allimera, personal fees from Bayer, personal fees from Insight Instruments, personal fees from Novartis, outside the submitted work; SF reports personal fees from Roche, outside the submitted work; MMM reports personal fees from Allergan, personal fees from Bayer, personal fees from Novartis, personal fees from Heidelberg Engineering, personal fees from Alcon, personal fees from Zeiss, outside the submitted work; RGS reports personal fees from Allergan, personal fees from Novartis, outside the submitted work; SM has nothing to disclose. PC reports personal fees from Novartis, outside the submitted work; PS has nothing to disclose. AL reports personal fees from Alcon, personal fees from Bayer, outside the submitted work; TB reports personal fees from Alcon, personal fees from Novartis, personal fees from Alimera, personal fees from Bayer, personal fees from Heidelberg, outside the submitted work.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Presented at DOG 2017115th DOG Congress28.9. – 1.10.2017Estrel Congress & Messe Center Berlin

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