Surgical Results in Ocriplasmin Candidates With Symptomatic Vitreomacular Traction Syndrome.

PURPOSE: To report surgical outcomes in a series of cases with symptomatic vitreomacular traction that met MIVI-TRUST (Microplasmin for intravitreous injection-traction release without surgical treatment) criteria for ocriplasmin use who underwent primary 25-gauge vitrectomy. MATERIALS AND METHODS: A single-center retrospective chart review study was performed in patients who underwent primary 25-gauge vitrectomy for symptomatic vitreomacular traction (VTM) from January 2013 through January 2016. Pre- and postoperative visual acuity (measured by the early treatment diabetic retinopathy acuity test), and posterior hyaloid focal attachment to the macula (demonstrated by high-definition optical coherence tomography) were analyzed. In addition, intra- and postoperative complications were obtained from medical records. RESULTS: Fifteen consecutive cases of symptomatic VMT traction that underwent primary 25-gauge vitrectomy were included. All met the MIVI-TRUST criteria for ocriplasmin use. In all cases, VMT resolution, macular hole closure, and improvement in best corrected visual acuity (BCVA) were observed. Mean visual acuity improved from 56.53 ± 16.04 letters at baseline to 73.13 ± 7.46 letters at 24 weeks of follow-up. The mean BCVA improvement from baseline was 16.60 letters (range 6-44), which was statistically significant (P < 0.0001). Ten of fifteen patients (66.6%) showed significant improvement of their BCVA to 20/40 or better (70 or more in ETDRS visual acuity test). No significant intra- or postoperative complications were documented. CONCLUSIONS: Primary 25-gauge pars plana vitrectomy in eyes with symptomatic vitreomacular traction is able to efficiently resolve VMT and macular holes, improving vision in candidates for intravitreal injection of ocriplasmin. This well-tolerated surgical procedure may be a reliable and predictable alternative for resolving VMT pathology.

Valores de proteinuria y daño vascular en gestantes sanas, preeclámpticas y con hipertensión no proteinúrica, evaluados por ultrasonografía vascular / Levels of proteinuria and vascular damage in healthy pregnant, preeclamptic, and non-proteinuric hypertensive women, assessed by vascular ultrasonography

Objetivo: Comparar si la ultrasonografía vascular esmás eficaz en diagnosticar daño vascular que laproteinuria.Sujetos y métodos: A 40 gestantes sanas (GS), 35preeclámpticas (GP) y 35 con hipertensión inducidapor el embarazo, sin proteinuria (GNP), de loshospitales Yanahuara y Nacional del Sur, EsSalud, enArequipa, Perú, se les midieron los valores de presiónarterial y proteinuria, y se les realizó unaultrasonografía vascular para evaluar la dilataciónmediada por flujo (DMF). Se realizaron comparacionesentre los 3 grupos mediante las pruebas de ANOVA oKruskal-Wallis, dependiendo de su distribución normalo no, respectivamente; se consideró estadísticamentesignificativo a un valor de p < 0,05.Resultados: Se obtuvieron valores de proteinuria de0,05 g/24 h; 2,57 g/24 h y 0,21 g/24 h, y valores deDMF de 0,66, 0,25 y 0,45 mm para los grupos GS,GP y GNP, respectivamente. La comparación delDMF entre grupos mostró diferencias significativaspara cada grupo (p < 0,01), pero en el caso de laproteinuria los valores del grupo GNP aúnpertenecen a rangos considerados normales(< 0,03 g/24 h). No se encontró relación entre laDMF y proteinuria.Conclusiones: La DMF evaluada por ultrasonografíadetecta una alteración vascular, inclusive en elgrupo de gestantes con hipertensión inducida delembarazo sin proteinuria

Objective: To compare the effectiveness of vascularultrasonography and proteinuria in diagnosingsystemic vascular damage.Subjects and methods: Forty healthy pregnantwomen, 35 with preeclampsia, and 35 with nonproteinurichypertension in the Yanahuara andNacional del Sur hospitals in Arequipa (Peru)underwent measurement of blood pressure,proteinuria, and ultrasonographic studies in thehumeral artery to obtain their flow-mediated dilation(FMD). Comparisons between the three groups weremade using ANOVA or Kruskal-Wallis tests,depending on whether the distribution was normalor non-normal, respectively. Values of P<0.05 wereconsidered statistically significant.Results: Proteinuria values were 0.05 g/24 h, 2.57g/24 h and 0.21 g/24 h while FMD values showedmean values of 0.66mm, 0.25mm, and 0.45mm forhealthy pregnant women, women with preeclampsiaand women with non-proteinuric hypertension,respectively. Comparison of FMD among groupsshowed significant differences among the groups(P<.01). However, proteinuria values in the groupwith non-proteinuric hypertension were within thenormal range (<0.03 g/24 h). No relation was foundbetween FMD and proteinuria.Conclusions: Ultrasonographic evaluation of FMDdetected vascular damage even in the group ofpregnant women with pregnancy-induced hypertensionwithout proteinuria