Treatment of vitreomacular traction syndrome with autologous plasmin enzyme.

Abstract

PURPOSE:

To determine whether intravitreal injection of autologous plasmin enzyme (APE) is effective in vitreomacular traction syndrome (VMTS) by improving visual acuity and restoring macular morphology.

METHODS:

A prospective study of 11 consecutive patients diagnosed with VMTS in the Ophthalmology Department from January to May, 2011.

INCLUSION CRITERIA:

best corrected visual acuity (BCVA) less than 0.5, and vitreomacular attachment in foveal area resulting in macular thickness>250 microns diagnosed by optical coherence tomography (Cirrus OCT, Carl Zeiss Meditec, Inc, Oberkochen, Germany).

EXCLUSION CRITERIA:

active proliferative diabetic retinopathy, axial myopia>26mm, vitrectomy, glaucoma, previous intravitreal injections and previous rhegmatogenous detachment. One to 3 monthly intravitreal injections of 0.2ml of APE were applied, interrupting if posterior vitreous detachment was attained. Wilcoxon's test was used for statistical analysis.

RESULTS:

A total of 12 eyes of 11 patients were treated. A complete posterior vitreous detachment was achieved in 4 (33%) eyes at the end of the study, 2 of them with one injection, and 2 with 3 monthly injections. Improvement of BCVA was statistically significant (P=.017) and the decrease in central macular thickness also was statistically significant (P=.016). There was only one complication: intraocular hypertension after injection that subsided with a new paracentesis.

CONCLUSIONS:

Intravitreal APE injections avoided vitrectomy in VMTS in one in every 3 patients.

• Authors: F J Rodríguez-Hurtado, M P Garrido Collado, V César Delgado Ceballos
• Journal: Archivos de la Sociedad Espanola de Oftalmologia (Arch Soc Esp Oftalmol) Vol. 90 Issue 6 Pg. 269-73 (Jun 2015) ISSN: 1989-7286 [Electronic] Spain
• PMID: 25843697 (Publication Type: Clinical Trial, Journal Article)
• Copyright: Copyright © 2011 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

Chemical References

• Fibrinolysin

Topics

• Aged
• Aged, 80 and over
• Female
• Fibrinolysin (administration & dosage, adverse effects, therapeutic use)
• Humans
• Intravitreal Injections
• Macula Lutea
• Male
• Ocular Hypotension (etiology)
• Prospective Studies
• Stress, Mechanical
• Syndrome
• Treatment Outcome
• Vitreous Detachment (drug therapy)