Enzymatic vitreolysis with ocriplasmin for vitreomacular traction and macular holes.

@article{Stalmans2012EnzymaticVW,
  title={Enzymatic vitreolysis with ocriplasmin for vitreomacular traction and macular holes.},
  author={Peter Stalmans and Matthew S. Benz and Arnd Gandorfer and Anselm Kampik and Aniz Girach and Steve Pakola and Julia A. Haller},
  journal={The New England journal of medicine},
  year={2012},
  volume={367 7},
  pages={
          606-15
        }
}
BACKGROUND Vitreomacular adhesion can lead to pathologic traction and macular hole. The standard treatment for severe, symptomatic vitreomacular adhesion is vitrectomy. Ocriplasmin is a recombinant protease with activity against fibronectin and laminin, components of the vitreoretinal interface. METHODS We conducted two multicenter, randomized, double-blind, phase 3 clinical trials to compare a single intravitreal injection of ocriplasmin (125 μg) with a placebo injection in patients with… 

Figures and Tables from this paper

COMPARISON OF RESOLUTION OF VITREOMACULAR TRACTION AFTER OCRIPLASMIN TREATMENT OR VITRECTOMY

Most patients treated with ocriplasmin for VMT showed a transient reduction of best-corrected visual acuity, accumulation of subretinal fluid, and a loss of the ellipsoid zone after the resolution of VMT.

Ocriplasmin for Treatment of Vitreomacular Traction: An Update

Subgroup analysis of clinical trials as well as post-marketing clinical series have aided in patient selection by identifying features associated with successful pharmacologic release of VMT with ocriplasmin, including adhesion diameter ≤1500 μm, absence of epiretinal membrane, phakic status, and age younger than 65.

IMPROVED EFFICACY OF OCRIPLASMIN FOR VITREOMACULAR TRACTION RELEASE AND TRANSIENT CHANGES IN OPTIC DISK MORPHOLOGY

Careful patient selection improves ocriplasmin efficacy and Transient optic disk morphology changes such as decreased cup/disk area ratio may occur in patients without VMT resolution.

The Efficacy and Safety Profile of Ocriplasmin in Vitreomacular Interface Disorders

Ocriplasmin (Jetrea, Thrombogenics USA, Alcon/Novartis EU), a recombinant protease approved in October 2012 for the treatment of symptomatic vitreomacular adhesion, is reviewed.

Intravitreal ocriplasmin: A breakthrough in the treatment of vitreomacular traction?

The aim of this review is to analyze and compare therapeutic options for symptomatic vitreomacular adhesion and vitreoretinal traction, with particular emphasis on microplasmin.

From the analysis of pharmacologic vitreolysis to the comprehension of ocriplasmin safety

This paper reviews the current knowledge and status of investigations regarding the use of ocriplasmin for pharmacologic vitreolysis and its safety, and dissolves vitreal proteins as well as possibly proteins associated with visual function in the retina, choroid, and lens.

Anatomical and visual outcomes following ocriplasmin treatment for symptomatic vitreomacular traction syndrome

This is the first study to quantify the extent of outer retinal changes seen in patients receiving ocriplasmin, and shows a significant anatomical effect and is accompanied by transient changes in theouter retinal structures visualised by SDOCT.

Profile of ocriplasmin and its potential in the treatment of vitreomacular adhesion

The outcome of the Phase II studies that indicated ocriplasmin was a safe and effective treatment for selected cases of symptomatic VMA and MH are revisited and the general success rate has not fully met expectations and needs to be proven in real-world clinical settings.

Vitrectomy After ocriplasmin for VitreOmacular adhesion Or Macular hole (VAVOOM) study

Eyes with persistent symptomatic VMT and/or MH have similarly high rates of pathology resolution as well as similar VA gains regardless of whether they received ocriplasmin prior to PPV.

Myopic macular hole detachment associated with intravitreal ocriplasmin

...

References

SHOWING 1-10 OF 36 REFERENCES

Enzymatic vitreolysis.

Some ongoing clinical trials that will determine the efficacy and safety of these novel therapies for diabetic retinopathy are described, including plasmin and microplasmin.

Anomalous posterior vitreous detachment: a unifying concept in vitreo-retinal disease

  • J. Sebag
  • Medicine
    Graefe's Archive for Clinical and Experimental Ophthalmology
  • 2004
Unifying the spectrum of vitreo-retinal diseases into the conceptual framework of APVD underscores that to more effectively treat, and ultimately prevent, these disorders it is necessary to replicate the two components of an innocuous PVD, i.e., gel liquefaction and vitreoschisis.

INTRAVITREAL INJECTION OF MICROPLASMIN FOR TREATMENT OF VITREOMACULAR ADHESION: Results of a Prospective, Randomized, Sham-Controlled Phase II Trial (The MIVI-IIT Trial)

The MIVI-IIT (traction) study evaluated the ability of a single or repeated injection of microplasmin to release vitreomacular traction and provided support for the potential of microPlasmin as a nonsurgical treatment for vitreOMacular adhesion.

POSTERIOR HYALOID CHANGES FOLLOWING INTRAVITREAL TRIAMCINOLONE AND MACULAR LASER FOR DIFFUSE DIABETIC MACULAR EDEMA

It is suggested that posterior hyaloid changes may play a more influential role in the response to intravitreal triamcinolone than laser treatment for diffuse diabetic macular edema.