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Dr Chang recently contributed to a My Health Career article on can ocriplasmin replace vitrectomy. He stated:

“The vitreous body is adherent to the internal limiting membrane of the retina through a biochemical glue composed of proteoglycans including fibronectin and laminin. As the vitreous liquefies with aging, these vitreoretinal adhesions weaken and a posterior vitreous detachment (PVD) occurs. Partial PVD can give rise to vitreoretinal interface disorders. This spectrum of pathology includes vitreomacular adhesion (VMA), vitreomacular traction (VMT) and macular hole (MH). These pathologies can give rise to impaired vision, metamorphopsia and visual field defects. Vitrectomy surgery has been shown to reliably treat these conditions, though it carries with it associated surgical risks.

Ocriplasmin is a protease with activity against fibronectin and laminin. Injected intravitreally, this drug cleaves the vitreoretinal interface and can induce posterior vitreous detachment. Phase III clinical trials have demonstrated the safety and efficacy of this drug, with resolution of VMA between 27 and 58%. With appropriate patient selection, rate of successful VMT release and MH closure can be optimised. This includes patients who are younger than 65 years of age, phakic, without epiretinal membrane, with full thickness MH < 250um and vitreomacular adhesion < 1500um.

Adverse events encountered with ocriplasmin are mostly related to self-limited visual disturbances such as photopsia. There have been observations of ERG abnormalities and ellipsoid layer alterations noted on OCT. These largely do not correlate with visual acuity, and the long-term ramifications of these changes are not clear.

Ocriplasmin serves as an important pharmacological tool in the management of vitreoretinal interface disorders. Though the success rate is not as high as vitrectomy surgery, in certain situations it may be a suitable first-line treatment. Further phase IV clinical trial data will refine the safety and efficacy profile of this drug.

The full article can be found here.

 


 

The following article appeared in the Wentworth Courier on the 7th July, 2010.

 

http://digitaledition.wentworthcourier.com.au/default.aspx?iid=37995&startpage=page0000019

 

The story was also mentioned in the Southern Courier on 11th July, 2010. Visit: http://southern-courier.whereilive.com.au/news/story/eyes-on-best-dad/