Ocriplasmin holds promise, but indications need to be clarified

COPENHAGEN, Denmark — Results of the MIVI-TRUST studies have shown that ocriplasmin effectively induces posterior vitreous detachment in cases of abnormal vitreomacular adhesion, but indications still have to be clarified, according to a specialist.

Vitreomacular adhesion can lead to a range of sequelae, including vitreomacular traction and macular hole, and is linked to retinal pathologies such as wet age-related macular degeneration, diabetic macular edema and retinal vein occlusion.

"We haven’t clearly identified the patients who may be suited for this kind of treatment, patients in whom we want to induce a non-aggressive [posterior vitreous detachment]," Albert Augustin, MD, said at the meeting of the European Society of Ophthalmology.

Albert Augustin

The MIVI-TRUST studies showed significantly more frequent resolution of vitreomacular adhesion and total posterior vitreous detachment in eyes injected with Jetrea (ocriplasmin, Novartis / ThromboGenics) compared with placebo, as well as a mean visual acuity gain of two lines. Nearly half of the eyes with a full-thickness macular hole less than 400 µm achieved complete closure.

Adverse events such as photopsia, vitreous floaters and blurred vision were transient and mild and "have to be expected as a consequence of the changes produced by ocriplasmin in the vitreous body," Augustin said.

Overall, ocriplasmin appears to be a promising new tool that provides an opportunity to treat patients with early symptoms associated with vitreomacular traction and reduces the risk of progression and further visual symptoms, according to Augustin.

Further studies and the new International Classification of Diseases of the Vitreomacular Interface are expected to provide useful insights on best indications, he said.

Disclosure: Augustin has no relevant financial disclosures.