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      Incomplete vitreomacular traction release using intravitreal ocriplasmin.

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          Abstract

          To report the clinical course of our first 7 consecutive patients treated with intravitreal ocriplasmin (Jetrea(®)).

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          Enzymatic vitreolysis with ocriplasmin for vitreomacular traction and macular holes.

          Matthew S Benz, Arnd Gandorfer, S Pakola … (2012)
          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. 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 symptomatic vitreomacular adhesion. The primary end point was resolution of vitreomacular adhesion at day 28. Secondary end points were total posterior vitreous detachment and nonsurgical closure of a macular hole at 28 days, avoidance of vitrectomy, and change in best-corrected visual acuity. Overall, 652 eyes were treated: 464 with ocriplasmin and 188 with placebo. Vitreomacular adhesion resolved in 26.5% of ocriplasmin-injected eyes and in 10.1% of placebo-injected eyes (P<0.001). Total posterior vitreous detachment was more prevalent among the eyes treated with ocriplasmin than among those injected with placebo (13.4% vs. 3.7%, P<0.001). Nonsurgical closure of macular holes was achieved in 40.6% of ocriplasmin-injected eyes, as compared with 10.6% of placebo-injected eyes (P<0.001). The best-corrected visual acuity was more likely to improve by a gain of at least three lines on the eye chart with ocriplasmin than with placebo. Ocular adverse events (e.g., vitreous floaters, photopsia, or injection-related eye pain--all self-reported--or conjunctival hemorrhage) occurred in 68.4% of ocriplasmin-injected eyes and in 53.5% of placebo-injected eyes (P<0.001), and the incidence of serious ocular adverse events was similar in the two groups (P=0.26). Intravitreal injection of the vitreolytic agent ocriplasmin resolved vitreomacular traction and closed macular holes in significantly more patients than did injection of placebo and was associated with a higher incidence of ocular adverse events, which were mainly transient. (Funded by ThromboGenics; ClinicalTrials.gov numbers, NCT00781859 and NCT00798317.).
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            Anatomical and visual outcomes following ocriplasmin treatment for symptomatic vitreomacular traction syndrome.

            Rishi Singh, Ang Li, Rumneek Bedi … (2014)
            To evaluate the anatomical and visual outcomes of patients treated with ocriplasmin for the treatment of symptomatic vitreomacular adhesion (sVMA), including vitreomacular traction syndrome and macular holes.
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              Correlation of transient vision loss with outer retinal disruption following intravitreal ocriplasmin.

              Aarti V. Shah, K. Bailey Freund, Prakesh S. Shah (2013)
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                Author and article information

                Journal
                Journal ID (iso-abbrev): Case Rep Ophthalmol
                Title: Case reports in ophthalmology
                Publisher: S. Karger AG
                ISSN (Print): 1663-2699
                Publication date (Electronic): January 22 2015
                Volume: 5
                Issue: 3
                Affiliations
                [1 ] Department of Ophthalmology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.
                Article
                Publisher Item ID: cop-0005-0455
                DOI: 10.1159/000370024
                PMC ID: 4296250
                PubMed ID: 25606039
                SO-VID: 42006ff5-81d7-42a8-bfee-ca6283db4690
                History

                Keywords: Jetrea®,Macular hole,Ocriplasmin,Vitrectomy,Vitreolysis,Vitreomacular adhesion,Vitreomacular traction
                Data availability:
                Keywords: Jetrea®, Macular hole, Ocriplasmin, Vitrectomy, Vitreolysis, Vitreomacular adhesion, Vitreomacular traction

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