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American Academy of Ophthalmology Meeting
November 09, 2012
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Specific baseline features help predict success of vitreomacular adhesion treatment

CHICAGO — A single injection of ocriplasmin yielded a positive resolution in patients with vitreomacular adhesion, a speaker said here.

Perspective from Michael A. Singer, MD

According to Subhransu Ray, MD, PhD, speaking at Retina Subspecialty Day preceding the joint meeting of the American Academy of Ophthalmology and Asia Pacific Academy of Ophthalmology, positive predictors of vitreomacular adhesion (VMA) resolution included an adhesion size less than 1,500 µm, an absence of epiretinal membrane, the presence of full-thickness macular hole, a patient younger than 65 years and the phakic status of the patient.

Independent baseline variables examined in the study included full-thickness macular hole, VMA diameter, lens status and the presence of epiretinal membrane.

Ray and colleagues analyzed the data from the Jetrea (ocriplasmin, ThromboGenics) phase 3 trial to assess the association of independent baseline features with pharmacologic VMA at day 28, which was the primary endpoint of the study. The trial included 652 eyes of 652 subjects.

“There were specific baseline features that were predictive of a higher success rate, but in the end, each individual patient must be evaluated and educated as to the benefits of three options available for symptomatic VMA: observation, ocriplasmin and surgical vitrectomy,” Ray said.

Disclosure: Ray receives clinical research support from Genentech, DRCR.net and ThromboGenics. He is also a consultant for Genentech and Santen.

Perspective

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Michael A. Singer, MD
Michael A. Singer, MD

The presentation by Subhransu Ray, MD, PhD, discussed what types of patients would benefit from the use of ocriplasmin (Jetrea, ThromboGenics). A number of factors were identified to be correlated with successful resolution of vitreomacular adhesion. These included adhesion size of less than 1,500 µm, presence of a full-thickness macular hole less than 400 µm, age 65 years or younger, the presence of an anatomic lens (phakic), and the absence of an epiretinal membrane. These data were based on the phase 3 MIVI-TRUST study program examining 652 subjects both in the United States and around the world.

For the clinician in practice, this information helps to distill this study down to useful pearls that will make a clinician’s first experience with this medication more positive. By knowing who is more likely to benefit from this medication, the physician is able to select suitable patients and counsel them appropriately. In addition, it also highlights who is not a good candidate, so both the physician and patient do not develop unrealistic expectations and end up being disappointed.

Michael A. Singer, MD
Retina Specialist, Medical Center of Ophthalmology Associates of San Antonio, Texas
Disclosures: Singer is a consultant for and receives research support from ThromboGenics.