Intravitreal injection of expansile perfluoropropane (c(3)f(8)) for the treatment of vitreomacular traction

Abstract

Purpose: To study the efficacy of a single intravitreal injection of expansile gas in releasing vitreomacular traction.

Design: Retrospective, interventional case series.

Methods: Fifteen eyes of 14 consecutive patients with symptomatic and persistent vitreomacular traction (>3 months' duration) on spectral-domain optical coherence tomography (SD OCT) received a single intravitreal injection of 0.3 mL 100% perfluoropropane (C(3)F(8)) as an alternative to pars plana vitrectomy (PPV). Primary outcome was the number of eyes with complete vitreomacular traction release on OCT 1 month following treatment. Secondary outcomes included changes in visual acuity (VA), foveal contour, central foveal thickness, and maximal foveal thickness 1 month following treatment, and final VA.

Results: Mean age (± SD) was 72.1 ± 12.6 years. Mean follow-up was 398.7 ± 174.4 days. Vitreomacular traction was idiopathic in 7 eyes and associated with diabetes in 6. One month following treatment, vitreomacular traction was released in 6 eyes (40%). Three further eyes (20%) had resolution of vitreomacular traction within 6 months, 4 (27%) underwent PPV, and 2 (13%) subsequently declined surgery. Foveal contour was restored in 7 eyes (47%). VA and central foveal thickness were similar 1 month following treatment, but maximal foveal thickness decreased by 65.8 μm (P = .041). Mean final VA decreased 0.03 logMAR units from baseline (P = .536). Eyes with vitreomacular traction release within 1 month had less extensive vitreomacular traction (P = .037), low vitreous face reflectivity, and maximal foveal thickness <500 μm (P = .004) pretreatment. There were no associated adverse events.

Conclusions: Intravitreal C(3)F(8) injection could offer a minimally invasive alternative to PPV in patients with symptomatic and persistent vitreomacular traction. It appears particularly effective in eyes with less extensive vitreomacular traction and low vitreous face reflectivity on SD OCT. Further studies are warranted.