Intravitreal plasmin without vitrectomy for macular edema secondary to branch retinal vein occlusion.

Abstract

OBJECTIVES:

To evaluate the effects and safety of intravitreal injections of autologous plasmin enzyme (APE), without vitrectomy, as a treatment for macular edema secondary to branch retinal vein occlusion.

DESIGN:

Prospective, comparative, interventional case series.

METHODS:

Patients were recruited and enrolled consecutively from February 1 through October 31, 2008, at the Retina Unit of the Hospital General Universitario, Valencia, Spain. An eye from 8 patients diagnosed as having macular edema due to branch retinal vein occlusion received an injection, after having received topical anesthesia, of 0.2 mL of APE, which had been obtained using a simplified method. Best-corrected visual acuity and central macular thickness measured by optical coherence tomography constitute the main outcome measures of the study.

RESULTS:

The mean (SD) central macular thickness decreased from 494.875 (68.82) to 226.375 (28.67) μm 1 month after APE injection and to 228.570 (21.53) μm after 6 months (P < .001). The best-corrected visual acuity (logarithm of the minimal angle of resolution) improved from a preoperative value of 0.552 (0.17) to 0.217 (0.087) (mean, 20/80-20/32, Snellen equivalent) at the end of follow-up (P < .01). No secondary effects were observed during 6 months of follow-up.

CONCLUSION:

This pilot study suggests that intravitreal injection of APE as a treatment for macular edema secondary to branch retinal vein occlusion improves central macular thickness and best-corrected visual acuity and may be a safe and effective alternative therapy for this condition if confirmed in controlled trials compared with standard care with longer follow-up.

• Authors: Patricia Udaondo, Manuel Díaz-Llopis, Salvador García-Delpech, David Salom, Francisco J Romero
• Journal: Archives of ophthalmology (Chicago, Ill. : 1960) (Arch Ophthalmol) Vol. 129 Issue 3 Pg. 283-7 (Mar 2011) ISSN: 1538-3601 [Electronic] United States
• PMID: 21402982 (Publication Type: Comparative Study, Controlled Clinical Trial, Journal Article)

Chemical References

• Fibrinolytic Agents
• Fibrinolysin

Topics

• Aged
• Female
• Fibrinolysin (administration & dosage)
• Fibrinolytic Agents (administration & dosage)
• Fluorescein Angiography
• Humans
• Intravitreal Injections
• Macular Edema (diagnosis, drug therapy, etiology)
• Male
• Microscopy, Acoustic
• Middle Aged
• Pilot Projects
• Prospective Studies
• Retinal Vein Occlusion (complications, diagnosis, drug therapy)
• Tomography, Optical Coherence
• Visual Acuity
• Vitrectomy
• Vitreous Body (drug effects)