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Microplasmin an alternative to monitoring patients with symptomatic vitreomacular adhesion

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KAANAPALI, Hawaii — Phase 3 trial data suggest microplasmin could be the first pharmacologic option to treat patients with symptomatic vitreomacular adhesion, providing retinal physicians with an alternative to watchful waiting, according to a presenter here.

"This is really a very exciting molecule because vitreomacular traction, or abnormalities of the vitreomacular or vitreoretinal interface, are common pathologic themes in a lot of the diseases we manage," said Steven D. Schwartz, MD, who presented findings from the MIVI-TRUST (Microplasmin for intravitreous injection-traction release without surgical treatment) program at Retina 2011.

Of 652 patients from centers in the U.S. and Europe, 26.5% had pharmacological resolution of symptomatic vitreomacular adhesion (P < .001 vs. placebo), and 34.5% of patients without an epiretinal membrane had pharmacological resolution of symptomatic vitreomacular adhesion (P < .001 vs. placebo). Additionally, 40% of patients had pharmacological closure of full-thickness macular hole (P < .001 vs. placebo) and 13.4% had induction of total posterior vitreous detachment (P < .001 vs. placebo).

All visual acuity and visual function outcomes favored microplasmin, and the molecule was generally well tolerated, Dr. Schwartz said.

Whereas current methods include watchful waiting or vitrectomy, microplasmin appears to be a useful alternative for treatment, according to Dr. Schwartz.

"It certainly does not work in everyone, but it is another arrow in the quiver that you can pull out, especially early on," he said.

• Disclosure: Dr. Schwartz receives research support from ThromboGenics.

Hawaiian Eye and Retina 2012 will be held January 15-20 at the Grand Wailea Resort & Spa in Maui. Learn more at OSNHawaiianEye.com or RetinaMeeting.com.