The Effect of Intravitreal Recombinant Tissue Plasminogen Activator Injection on Diabetic Tractional Fibrovascular Membranes: Proposed Criteria using Optical Coherence Tomography

Purpose: o evaluate the effect of intravitreal recombinant tissue plasminogen activator (rTPA) on diabetic tractional fibrovascular membranes (FVM) using the proposed optical coherence tomography (OCT) based measurement criteria. Methods: This prospective, interventional case series enrolled eyes that were candidates for vitrectomy. OCT images were obtained to study attached–detached retinal borders at baseline and on- week post-intravitreal rTPA injection using the follow-up scan protocols. Two independent graders assessed retinal detachment (RD) height, FVM height, FVM thickness, retinal thickness at the site of membrane attachment and release of retina-membrane touch point. Results: Nine eyes from nine individuals were included. Assessment of RD height, FVM height, FVM thickness and retinal thickness at touch point were feasible in 8/9 (88%), 7/9 (77%), 8/9 (88%) and 5/9 (55%) of eyes, respectively. There was an excellent agreement between the two graders in all of measurements (all ICC> 0.93). Release of retina-membrane touch point was not observed in any eyes. No statistically significant change was found in any of the measured parameters. Conclusion: Our proposed OCT-based measurement system in assessing diabetic FVM was reliable and feasible. We did not find any significant change in the status of diabetic FVM, one-week after intravitreal rTPA injection, using OCT-based measurements.