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Vitreolysis agents offer hope for patients with symptomatic vitreomacular adhesion
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CHICAGO – For those diagnosed early, pharmacologic vitreolysis agents may eliminate the need for vitrectomy, a presenter here said.
“This can provide an option for patients in a nonsurgical format, patients that have symptomatic vitreomacular adhesions and/or macular holes,” William F. Mieler, MD, OSN Retina/Vitreous Board Member, told colleagues at the American Society of Cataract and Refractive Surgery meeting.
Traditional treatment involves watching and waiting and then eventually implementing vitrectomy. However, researchers are now examining the use of pharmacologic vitreolysis agents to liquefy gel vitreous and/or lyse vitreoretinal adhesion, Dr. Mieler said.
This should resolve the underlying condition and subsequently improve vision, prevent progression and complications, and decrease the need for surgical intervention and its associated burden, he added.
While several drugs have been explored, none have yet received approval from the US Food and Drug Administration. However, ocriplasmin (microplasmin; ThromboGenics) has successfully completed its phase 3 MIVI-TRUST (Microplasmin for intravitreous injection-traction release without surgical treatment) trials, and approval is anticipated for late 2012.
“Hopefully, sometime in the next few months once this agent is approved, we will at least have this option if we inspect our patients carefully. Those patients with smaller areas of adhesions, smaller holes… may fare quite nicely with an injection alone and then be spared the need for vitrectomy,” Dr. Mieler said.
- Disclosure: Dr. Mieler is a consultant for Alcon, Alimera, Allergan, Genentech and Novartis.