TY  - JOUR
A1  - Stefanini, Francisco R.
A1  - Maia, Maurício
A1  - Falabella, Paulo
A1  - Pfister, Marcel
A1  - Niemeyer, Moritz
A1  - Kashani, Amir H.
A1  - Humayun, Mark S.
A1  - Koss, Michael Janusz
T1  - Profile of ocriplasmin and its potential in the treatment of vitreomacular adhesion
T2  - Clinical ophthalmology
N2  - The recent approval by the US Food and Drug Administration of ocriplasmin for the treatment of symptomatic vitreomacular adhesion (VMA), often associated with vitreomacular traction (VMT) and macular hole (MH), has brought new attention to the field of pharmacologic vitreolysis. The need for an enzyme to split the vitreomacular interface, which is formed by a strong adhesive interaction between the posterior vitreous cortex and the internal limiting membrane, historically stems from pediatric eye surgery. This review summarizes the different anatomic classifications of posterior vitreous detachment or anomalous posterior vitreous detachment and puts these in the context of clinical pathologies commonly observed in clinical practice of the vitreoretinal specialist, such as MH, VMT, age-related macular degeneration, and diabetic macular edema. We revisit the outcome of the Phase II studies that indicated ocriplasmin was a safe and effective treatment for selected cases of symptomatic VMA and MH. Release of VMA at day 28 was achieved by 26.5% of patients in the ocriplasmin group versus 10.1% in the placebo group (P<0.001). Interestingly, for MHs, the numbers were more remarkable. Predictive factors for successful ocriplasmin treatment were identified for VMT (VMA diameter smaller than 1,500 µm) and MH (smaller than 250 µm). In comparison with the highly predictable outcome after vitrectomy, the general success rate of ocriplasmin not under clinical trial conditions has not fully met expectations and needs to be proven in real-world clinical settings. The ocriplasmin data will be compared in the future with observational data on spontaneous VMA release, will help retina specialists make more accurate predictions, and will improve outcome rates.
KW  - ocriplasmin
KW  - microplasmin
KW  - posterior vitreous detachment
KW  - vitreomacular traction
KW  - macular hole
KW  - pharmacologic vitreolysis
Y1  - 2014
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/34370
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-343704
SN  - 1177-5483
SN  - 1177-5467
N1  - This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution - Non Commercial (unported, v3.0) License. The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. Permissions beyond the scope of the License are administered by Dove Medical Press Limited. Information on how to request permission may be found at: http://www.dovepress.com/permissions.php
VL  - 8
SP  - 847
EP  - 856
PB  - Dove Medical Press
CY  - Auckland, New Zealand
ER  -