Clinical characteristics and selection of treatment modality for patients with vitreomacular traction: real-world implementation of NICE guidance (TA297)

Edward William James Pritchard,1 Shams-Ulislam Ilyas,1 Soha Khaled Amar,2 Yit Chuin Yang,3 Nirodhini Narendran1 1Ophthalmology Department, Wolverhampton Eye Infirmary, New Cross Hospital, Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, 2College of Medical and Dental Sciences, University of...

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Autores principales:	Pritchard EWJ, Ilyas SU, Amar SK, Yang YC, Narendran N
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2016
Materias:	Vitreomacular traction Macular hole Ocriplasmin Vision loss Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/c811482e8d074e6c96a50e9726014739
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spelling	oai:doaj.org-article:c811482e8d074e6c96a50e97260147392021-12-02T05:23:55ZClinical characteristics and selection of treatment modality for patients with vitreomacular traction: real-world implementation of NICE guidance (TA297)1177-5483https://doaj.org/article/c811482e8d074e6c96a50e97260147392016-01-01T00:00:00Zhttps://www.dovepress.com/clinical-characteristics-and-selection-of-treatment-modality-for-patie-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Edward William James Pritchard,1 Shams-Ulislam Ilyas,1 Soha Khaled Amar,2 Yit Chuin Yang,3 Nirodhini Narendran1 1Ophthalmology Department, Wolverhampton Eye Infirmary, New Cross Hospital, Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, 2College of Medical and Dental Sciences, University of Birmingham, 3Optometry Department, Faculty of Life and Health Sciences, Aston University, Birmingham, UK Aim: To investigate the qualitative aspects in patient selection and the quantitative impact of disease burden in real world treatment of vitreomacular traction (VMT) and implementation of the National Institute for Health and Care Excellence (NICE) guidance (TA297). Methods: A monocentric, retrospective review of consecutive patients undergoing optical coherence tomography (OCT) imaging over a 3 month period. Patients with VMT in at least one eye were identified for further data collection on laterality, visual acuity, symptoms, presence of epiretinal membrane, macular hole and treatment selection. Results: A total of 3472 patients underwent OCT imaging with a total of 6878 eyes scanned. Out of 87 patients, 74 patients had unilateral VMT (38 right, 36 left) and 13 patients had bilateral VMT. Eighteen patients with unilateral VMT satisfied NICE criteria of severe sight problems in the affected eye. Eight were managed for a coexisting pathology, one refused treatment, one patient did not attend, two closed spontaneously, and one received ocriplasmin prior to the study start date. Only two patients with unilateral VMT received ocriplasmin and three underwent vitrectomy. Those failing to meet NICE criteria for unilateral VMT were predominantly asymptomatic (n=49) or had coexisting ERM (n=5) or both (n=2). Conclusion: Ocriplasmin provides an alternative treatment for patients with symptomatic VMT. Our data shows that the majority of patients with VMT do not meet NICE TA297 primarily due to lack of symptoms. Those meeting NICE criteria, but not treated, tended to have coexisting macular pathology. Variation in patient selection due to subjective factors not outlined in NICE guidance suggests that real world outcomes of ocriplasmin therapy should be interpreted with caution. Keywords: vitreomacular traction, posterior vitreous detachment, pharmacologic vitreolysis, ocriplasminPritchard EWJIlyas SUAmar SKYang YCNarendran NDove Medical PressarticleVitreomacular traction Macular hole Ocriplasmin Vision lossOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2016, Iss Issue 1, Pp 79-85 (2016)
institution	DOAJ
collection	DOAJ
language	EN
topic	Vitreomacular traction Macular hole Ocriplasmin Vision loss Ophthalmology RE1-994
spellingShingle	Vitreomacular traction Macular hole Ocriplasmin Vision loss Ophthalmology RE1-994 Pritchard EWJ Ilyas SU Amar SK Yang YC Narendran N Clinical characteristics and selection of treatment modality for patients with vitreomacular traction: real-world implementation of NICE guidance (TA297)
description	Edward William James Pritchard,1 Shams-Ulislam Ilyas,1 Soha Khaled Amar,2 Yit Chuin Yang,3 Nirodhini Narendran1 1Ophthalmology Department, Wolverhampton Eye Infirmary, New Cross Hospital, Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, 2College of Medical and Dental Sciences, University of Birmingham, 3Optometry Department, Faculty of Life and Health Sciences, Aston University, Birmingham, UK Aim: To investigate the qualitative aspects in patient selection and the quantitative impact of disease burden in real world treatment of vitreomacular traction (VMT) and implementation of the National Institute for Health and Care Excellence (NICE) guidance (TA297). Methods: A monocentric, retrospective review of consecutive patients undergoing optical coherence tomography (OCT) imaging over a 3 month period. Patients with VMT in at least one eye were identified for further data collection on laterality, visual acuity, symptoms, presence of epiretinal membrane, macular hole and treatment selection. Results: A total of 3472 patients underwent OCT imaging with a total of 6878 eyes scanned. Out of 87 patients, 74 patients had unilateral VMT (38 right, 36 left) and 13 patients had bilateral VMT. Eighteen patients with unilateral VMT satisfied NICE criteria of severe sight problems in the affected eye. Eight were managed for a coexisting pathology, one refused treatment, one patient did not attend, two closed spontaneously, and one received ocriplasmin prior to the study start date. Only two patients with unilateral VMT received ocriplasmin and three underwent vitrectomy. Those failing to meet NICE criteria for unilateral VMT were predominantly asymptomatic (n=49) or had coexisting ERM (n=5) or both (n=2). Conclusion: Ocriplasmin provides an alternative treatment for patients with symptomatic VMT. Our data shows that the majority of patients with VMT do not meet NICE TA297 primarily due to lack of symptoms. Those meeting NICE criteria, but not treated, tended to have coexisting macular pathology. Variation in patient selection due to subjective factors not outlined in NICE guidance suggests that real world outcomes of ocriplasmin therapy should be interpreted with caution. Keywords: vitreomacular traction, posterior vitreous detachment, pharmacologic vitreolysis, ocriplasmin
format	article
author	Pritchard EWJ Ilyas SU Amar SK Yang YC Narendran N
author_facet	Pritchard EWJ Ilyas SU Amar SK Yang YC Narendran N
author_sort	Pritchard EWJ
title	Clinical characteristics and selection of treatment modality for patients with vitreomacular traction: real-world implementation of NICE guidance (TA297)
title_short	Clinical characteristics and selection of treatment modality for patients with vitreomacular traction: real-world implementation of NICE guidance (TA297)
title_full	Clinical characteristics and selection of treatment modality for patients with vitreomacular traction: real-world implementation of NICE guidance (TA297)
title_fullStr	Clinical characteristics and selection of treatment modality for patients with vitreomacular traction: real-world implementation of NICE guidance (TA297)
title_full_unstemmed	Clinical characteristics and selection of treatment modality for patients with vitreomacular traction: real-world implementation of NICE guidance (TA297)
title_sort	clinical characteristics and selection of treatment modality for patients with vitreomacular traction: real-world implementation of nice guidance (ta297)
publisher	Dove Medical Press
publishDate	2016
url	https://doaj.org/article/c811482e8d074e6c96a50e9726014739
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Clinical characteristics and selection of treatment modality for patients with vitreomacular traction: real-world implementation of NICE guidance (TA297)

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