Intravitreal Plasmin Without Vitrectomy for Macular Edema Secondary to Branch Retinal Vein Occlusion

Udaondo, Patricia

doi:10.1001/archophthalmol.2011.8

Cited by 22 publications

(10 citation statements)

References 22 publications

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“…Several previous studies [12]–[17] determined that optical coherence tomography can help in the evaluation of macular edema in diabetic or non-diabetic patients, and also help in the follow-up of the patients during treatment to establish quantitative or qualitative responses to therapy.…”

Section: Discussionmentioning

confidence: 99%

RETRACTED ARTICLE: Cental macular thickness in patients with type 2 diabetes mellitus without clinical retinopathy

Demir¹,

Oba²,

Dirim³

et al. 2013

BMC Ophthalmol

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BackgroundAn increase in macular thickness due to fluid accumulation in the macula in patients with diabetes mellitus. Optical coherence tomography (OCT) has been shown to be highly reproducible in measuring macular thickness in normal individuals and diabetic patients. OCT can detect subtle changes of macular thickness. The aim of this study is to compare central macular thickness (CMT) of diabetic patients with type 2 diabetes without clinical retinopathy and normal controls, in order to assess possible increased macular thickness associated with diabetes mellitus.MethodsOptical coherence tomography (OCT) measurements were performed in 124 eyes of 62 subjects with diabetes mellitus without clinically retinopathy (study group: 39 female, 23 male, mean age: 55.06 ± 9.77 years) and in 120 eyes of 60 healthy subjects (control group: 35 female, 25 male, mean age: 55.78 ± 10.34 years). Blood biochemistry parameters were analyzed in all cases. The data for central macular thickness (at 1 mm) and the levels of the fasting plasma glucose and glycosylated hemoglobin (HbA1c) were compared in both groups.ResultsThe mean central macular thickness was 232.12 ±24.41 μm in the study group and 227.19 ± 29.94 μm in the control group.The mean HbA1c level was 8.92 ± 2.58% in the study group and 5.07 ± 0.70% in the control group (p=0.001). No statistically significant relationship was found between CMT, HbA1c, and fasting plasma glucose level in either group (p=0.05).ConclusionsCentral macular thickness was not significantly thicker in patients with type 2 diabetes without clinical retinopathy than in healthy subjects.

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Section: Discussionmentioning

confidence: 99%

RETRACTED ARTICLE: Cental macular thickness in patients with type 2 diabetes mellitus without clinical retinopathy

Demir¹,

Oba²,

Dirim³

et al. 2013

BMC Ophthalmol

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“…One comparative study reported significantly higher visual acuities at 1 year follow-up in patients with DME treated with APE compared with those not receiving such treatment 134. More recently, a small prospective study found that intravitreal APE without vitrectomy improved central macular thickness and visual acuity in eyes with macular edema complicating branch RVO 137. Of note, many groups reported varying degrees of vitreous liquefaction following APE administration,77,127,131,133,135,136 although several others either did not comment or noted the lack of liquefaction 134.…”

Section: Vitreolytic Agentsmentioning

confidence: 99%

Emerging nonsurgical methods for the treatment of vitreomacular adhesion: a review

Schneider¹,

Johnson²

2011

OPTH

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With the dissemination of optical coherence tomography over the past two decades, the role of persistent vitreomacular adhesion (VMA) in the development of numerous macular pathologies – including idiopathic macular hole, vitreomacular traction syndrome, cystoid and diabetic macular edema, neovascularization in diabetic retinopathy and retinal vein occlusion, exudative age-related macular degeneration, and myopic traction maculopathy – has been established. While invasive vitreoretinal procedures have long been utilized to address complications related to these disorders, such an approach is hampered by incomplete vitreoretinal separation and vitreous removal, surgical complications, and high costs. In light of such limitations, investigators have increasingly looked to nonsurgical means for the treatment of persistent pathologic VMA. Chief among these alternative measures is the intravitreal application of pharmacologic agents for the induction of vitreous liquefaction and/or vitreoretinal separation, an approach termed pharmacologic vitreolysis. This article aims to review the available evidence regarding the use of pharmacologic agents in the treatment of VMA-related pathology. In addition, a discussion of vitreous molecular organization and principles of physiologic posterior vitreous detachment is provided to allow for a consideration of vitreolytic agent mode of action and molecular targets.

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“…Sakuma et al17 and Udaondo et al18 evaluated the effects and safety of intravitreal injections of APE, without vitrectomy, as a treatment for macular edema secondary to branch retinal vein occlusion and reported that IAP improves CMT and BCVA and may be a safe and effective alternative therapy for this condition.…”

Section: Discussionmentioning

confidence: 99%

Intravitreal autologous plasmin as a therapeutic modality for diffuse diabetic macular edema

Elsawy¹

2012

OPTH

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ObjectivesTo evaluate the outcome of vitreolysis using intravitreal autologous plasmin (IAP) injection as a sole therapeutic modality for patients with diffuse diabetic macular edema in comparison to triamcinolone acetonide (TA).Patients and methodsThe study included 50 diabetic patients, 18 males and 32 females, with a mean age of 66.4 ± 7.8 years and a mean duration of diabetes of 14 ± 2.4 years. All patients underwent full ophthalmologic examination and were allocated randomly into two groups: the TA group received 4 mg TA and the IAP group received 0.2 mL freshly home-prepared autologous plasmin. Outcome measures included determination of central macular thickness (CMT), best-corrected visual acuity (BCVA), and intraocular pressure (IOP) at 1, 3, and 6 months.ResultsBoth TA and plasmin induced significant decrease of CMT compared to baseline thickness with nonsignificant difference between both groups. The extent of decrease of CMT reached a peak at 1 month after injection and then started to decline until the sixth month, but was significantly thinner when compared to baseline thickness. However, the extent of deterioration was less evident with plasmin as the difference between follow-up measures at 3 and 6 months were nonsignificant compared to the 1-month measure and to each other. BCVA was significantly improved compared to baseline BCVA with a nonsignificant difference between both groups at 1 and 3 months, but at 6 months, mean BCVA significantly deteriorated in TA group compared to that recorded at 3 months, but not in the IAP group. At 3 and 6 months after injection, IOP was significantly lower in both groups compared to IOP at 1 month despite being significantly higher in the TA group, but IOP was nonsignificantly lower in the IAP group compared to baseline. Moreover, mean IOP estimated at 3 and 6 months was significantly higher in the TA group compared to the IAP group.ConclusionVitreolysis using IAP injection provided effective diminution of CMT with improvement of BCVA and this effect was longer lasting and safer than intravitreal injection of TA without concomitant increase of IOP.

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Intravitreal Plasmin Without Vitrectomy for Macular Edema Secondary to Branch Retinal Vein Occlusion

Abstract: 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.

Cited by 22 publications

References 22 publications

RETRACTED ARTICLE: Cental macular thickness in patients with type 2 diabetes mellitus without clinical retinopathy

RETRACTED ARTICLE: Cental macular thickness in patients with type 2 diabetes mellitus without clinical retinopathy

Emerging nonsurgical methods for the treatment of vitreomacular adhesion: a review

Intravitreal autologous plasmin as a therapeutic modality for diffuse diabetic macular edema

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