Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
JCR Impact Factor (IF) – 2.1 (5-Year IF – 2.0)
Journal Citation Indicator (JCI) (2023) – 0.4
Scopus CiteScore – 3.7 (CiteScore Tracker 3.8)
Index Copernicus  – 171.00; MNiSW – 70 pts

ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
Periodicity – monthly

Download original text (EN)

Advances in Clinical and Experimental Medicine

2017, vol. 26, nr 3, May-June, p. 527–531

doi: 10.17219/acem/62122

Publication type: review

Language: English

Download citation:

  • BIBTEX (JabRef, Mendeley)
  • RIS (Papers, Reference Manager, RefWorks, Zotero)

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

Anna E. Mec-Słomska1,A,B,C,D, Joanna Adamiec-Mroczek2,B,E,F, Ewa Kuźmicz3,B, Marta Misiuk-Hojło2,E

1 Provincial Hospital Center, Jelenia Góra, Poland

2 Department and Clinic of Ophthalmology, Wroclaw Medical University, Poland

3 Medical Center Aldemed, Zielona Góra, Poland

Abstract

Vitreoretinal interface pathologies, such as vitreomacular traction syndrome, epiretinal membranes and macular holes are sight-threatening conditions and one of the important causes of vision defects and vision loss. To this date, vigilance with observation of how the vitreomacular traction resolves, or vitreoretinal surgery in more severe cases, were the only treatment options. Recent rapid progress in ophthalmology, especially in diagnostic and visualization techniques, provided better insight into the mechanisms taking place on the vitreoretinal surface, which enabled a more accurate selection of treatment options. Development of ophthalmic pharmacological procedures, such as treatment of vitreomacular traction syndrome with ocriplasmin, constitutes an innovative breakthrough in ophthalmology. The enzyme is a genetically engineered form of human plasmin, a component of blood coagulation cascade that has been envisioned for human therapy since 1950s. It has never been used for vitreolysis in ophthalmology before. The aim of this review is to analyze and compare therapeutic options for symptomatic vitreomacular adhesion and vitreoretinal traction, with particular emphasis on microplasmin. We reviewed the results of recent studies comparing ocriplasmin to other widespread treatment options, such as pars plana vitrectomy.

Key words

vitreoretinal surgery, optical coherence tomography, microplasmin, vitreous body, vitreous detachment

References (40)

  1. Matsumoto B, Blanks JC, Ryan SJ. Topographic variations in the rabbit and primate internal limiting membrane. Invest Ophthalmol Vis. Sci. 1984;25(1):71–82.
  2. Wang J, McLeod D, Henson DB, Bishop PN. Age-dependent changes in the basal retinovitreous adhesion. Invest Ophthalmol Vis Sci. 2003;44(5):1793–1800.
  3. Sebag J. Balazs EA. Morphology and ultrastructure of human vitreous fibres. Invest Ophthalmol Vis Sci. 1989;30:1867–1871.
  4. Steel DHW. Lotery AJ. Idiopathic vitreomacular traction and macular hole: A comprehensive review of pathophysiology, diagnosis, and treatment. Eye. 2013;Suppl 1:S1–21. doi: 10.1038/eye.2013.212.
  5. Sebag J. Ageing of the vitreous. Eye. 1987;1:254–262.
  6. Uchino E, Uemura A, Ohba N. Initial stages of posterior vitreous detachment in healthy eyes of older persons evaluated by optical coherence tomography. Arch Ophthalmol. 2001;119(10):1475–1479.
  7. Johnson MW. Perifoveal vitreous detachment and its macular complications. Trans Am Ophthalmol Soc. 2005;103:537–567.
  8. Paolo Carpineto, Luca Di Antonio, Agbeanda Aharrh-Gnama, Vincenzo Ciciarelli, Leonardo Mastropasqua. Diagnosing and treating vitreomacular adhesion. Eur Ophthal Rev. 2011,5(1):69–73.
  9. Duker JS, Kaiser PK, Binder S, et al. The International Vitreomacular Traction Study Group classification of vitreomacular adhesion, traction, and macular hole. Ophthalmology. 2013;120(12):2611–2619. doi: 10.1016/j.ophtha.2013.07.042.
  10. Sebag J. Molecular biology of pharmacologic vitreolysis. Trans Am Ophthalmol Soc. 2005;103:473–494.
  11. Smiddy WE, Green WR, Michels RG, de la Cruz Z. Ultrastructural studies of vitreomacular traction syndrome. Am. J. Ophthalmol. 1989;107(2):177–185.
  12. Shinoda K, Hirakata A, Hida T et al. Ultrastructural and immunohistochemical findings in five patients with vitreomacular traction syndrome. Retina. 2000;20(3):289–293.
  13. Mojana F, Cheng L, Bartsch DU, et al. The role of abnormal vitreomacular adhesion in age-related macular degeneration: Spectral optical coherence tomography and surgical results. Am J Ophthalmol. 2008;146(2):218–227. doi: 10.1016/j.ajo.2008.04.027.
  14. Jackson TL, Nicod E, Angelis A, et al. Vitreous attachment in age-related macular degeneration, diabetic macular edema, and retinal vein occlusion: A systematic review and metaanalysis. Retina. 2013;33(6):1099–1108. doi: 10.1097/IAE.0b013e31828991d6.
  15. Shao Lei , Wei Wenbin. Vitreomacular traction syndrome. Chin Med J. 2014;127(8): 1566–1571.
  16. Jaycock PD, Bunce C, XingW, et al. Outcomes of macular hole surgery: Implications for surgical management and clinical governance. Eye. 2005;19:879–884.
  17. Theodossiadis GP, Grigoropoulos VG, Theodoropolou S, Datseris I, Theodossiadis PG. Spontaneous resolution of vitreomacular traction demonstrated by spectral-domain optical coherence tomography. Am J Ophthalmol. 2014;157:842–851.
  18. Sayegh RG, Georgopoulos M, Geitzenauer W, Simader C, Kiss C, Schmidt-Erfurth U. High-resolution optical coherence tomography after surgery for vitreomacular traction Ophthalmology. 2010;117(10):2010–2017 doi: 10.1016/j.ophtha.2010.01.041.
  19. Rizzo S, Patelli F, Chow DR. Essentials in Ophthalmology. Vitreo-retinal Surgery. Springer;2009:69–87.
  20. Kunimoto DY, Kaiser RS, Willis Eye Research Service: Incidence of Endophthalmitis after 20- and 25- Gauge Vitrectomy. Ophthalmology. 2007;114(12):2133-2137.
  21. Sharma T, Virdi DS, Parikh S, et al. A case-control study of suprachoroidal hemorrhage during pars plana vitrectomy. Ophthalmic Surg Lasers.1997;28(8):640–644.
  22. Ghoraba HH, Zayed AI. Suprachoroidal hemorrhage as a complication of vitrectomy. Ophthalmic Surg Lasers. 2001;32(4):281–288.
  23. De Nie KF, Crama N, Tilanus MA, Klevering BJ, Boon CJ. Pars plana vitrectomy for disturbing primary vitreous floaters: Clinical outcome and patient satisfaction. Graefes Arch Clin Exp Ophthalmol. 2013;251(5):1373–1382.
  24. Chung CP, Hsu SY, Wu WC. Cataract formation after pars plana vitrectomy. Kaohsiung J Med Sci. 2001;17(2):84–89.
  25. Mason JO 3rd, Neimkin MG, Mason JO 4th, et al. Safety, efficacy, and quality of life following sutureless vitrectomy for symptomatic vitreous floaters. Retina. 2014;34(6):1055–1061.
  26. Rahman R, Murray CD, Stephenson J. Risk factors for iatrogenic retinal breaks induced by separation of posterior hyaloid face during 23-gauge pars plana vitrectomy. Eye. 2013;27(5):652–656. doi: 10.1038/eye.2013.6.
  27. de Smet MD, Valmaggia C, Zarranz-Ventura J, Willekens B. Microplasmin: Ex vivo characterization of its activity in porcine vitreous. Invest Ophthalmol Vis Sci. 2009;50:814–819.
  28. Stalmans P, Benz MS, Gandorfer A, et al. Enzymatic vitreolysis with ocriplasmin for vitreomacular traction and macular holes. N Engl J Med. 2012;367:606–615. doi: 10.1056/NEJMoa1110823.
  29. Stalmans P, de Laey C, de Smet M, van Dijkman E, Pakola S. Intravitreal injection of microplasmin for treatment of vitreomacular adhesion: Results of a prospective, randomized, sham-controlled phase II trial (the MIVI-IIT trial). Retina. 2010;30:1122–1127.
  30. European Medicines Agency. Assessment report: Jetrea; 17 January 2013 EMA/CHMP/74766/2013. Committee for Medicinal Products for Human Use (CHMP).
  31. de Smet MD, Jonckx B, Vanhove M, van Calster J, Stalmans P, Stassen JM. Pharmacokinetics of ocriplasmin in vitreous. IOVS. 2012;53(13).
  32. Haller JA, Stalmans P, Benz MS, et al. Efficacy of intravitreal ocriplasmin for treatment of vitreomacular adhesion: Subgroup analyses from two randomized trials. Ophthalmology. 2015;122(1):117–122. doi: 10.1016/j.ophtha.2014.07.045.
  33. DeCroos FC, Toth CA, Folgar FA, et al. Characterization of vitreoretinal interface disorders using OCT in the interventional phase 3 trials of ocriplasmin. Invest Ophthalmol Vis Sci. 2012;53(10):6504–6511.
  34. Song SJ, Smiddy WE. Ocriplasmin for symptomatic vitreomacular adhesion: An evidence-based review of its potential. Core Evid. 2014;9:51–59. Published online Mar 21, 2014. doi: 10.2147/CE.S39363
  35. Miller JB, Kim LA, Wu DM, Vavvas DG, Eliott D, Husain D. Ocriplasmin for treatment of stage 2 macular holes: Early clinical results. Ophthal Surg Lasers Imaging Retina. 2014;45(4):293–297. doi: 10.3928/23258160-20140709-05.
  36. Song SJ, Smiddy WE. Ocriplasmin for symptomatic vitreomacular adhesion: An evidence-based review of its potential. Core Evid. 2014;9:51–59. doi: 10.2147/CE.S39363.
  37. US Food and Drug Administration. Jetrea (ocriplasmin) Intravitreal Injection Medical Review. October 17, 2012. http://www.accessdata.fda.gov/drugsatfda_docs/nda/2012/125422Orig1s000MedR.pdf. Accessed May 22, 2013.
  38. Tibbetts MD, Reichel E, Witkin AJ. Vision loss after intravitreal ocriplasmin: Correlation of spectral-domain optical coherence tomography and electroretinography. JAMA Ophthalmol. 2014;132(4):487–490. doi: 10.1001/jamaophthalmol.2013.8258.
  39. Fahim AT, Khan NW, Johnson MW. Acute panretinal structural and functional abnormalities after intravitreous ocriplasmin injection. JAMA Ophthalmol. 2014;132(4):484–486. doi: 10.1001/jamaophthalmol.2013.8142.
  40. Silva RA, Moshfeghi DM, Leng T. Retinal breaks due to intravitreal ocriplasmin. Clin Ophthalmol. 2014;8:1591–1594. doi: 10.2147/OPTH.S68037.