Efficacy of intravitreal ocriplasmin for treatment of vitreomacular adhesion: subgroup analyses from two randomized trials

Ophthalmology. 2015 Jan;122(1):117-22. doi: 10.1016/j.ophtha.2014.07.045. Epub 2014 Sep 18.

Abstract

Purpose: To evaluate the efficacy of a single intravitreal injection of ocriplasmin 125 μg across relevant subpopulations of patients with symptomatic vitreomacular adhesion (VMA)/vitreomacular traction (VMT), including when associated with macular hole.

Design: Two multicenter, randomized, placebo-controlled, double-masked, 6-month studies.

Participants: A total of 652 randomized patients (464 receiving ocriplasmin; 188 receiving placebo).

Methods: A single intravitreal injection of ocriplasmin 125 μg or placebo in the study eye.

Main outcome measures: Prespecified subgroup analyses were conducted to evaluate the effects on the proportion of patients with nonsurgical resolution of focal VMA at day 28, nonsurgical full-thickness macular hole (FTMH) closure at month 6, and categoric improvement in best-corrected visual acuity (BCVA) at month 6.

Results: Resolution of VMA at day 28 was achieved more often in younger patients (<65 years), eyes without epiretinal membrane, eyes with FTMH, phakic eyes, and eyes with a focal VMA ≤ 1500 μm. Eyes with FTMH width ≤ 250 μm were more likely to achieve nonsurgical FTMH closure. Categoric ≥ 2-line and ≥ 3-line improvement in BCVA occurred more often in younger patients (<65 years) and in patients with a lower baseline BCVA (<65 letters). Treatment differences in favor of ocriplasmin were generally observed across each subgroup of subpopulations studied.

Conclusions: Subgroup analyses confirmed the positive effect of ocriplasmin across relevant subpopulations.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Double-Blind Method
  • Eye Diseases / diagnosis
  • Eye Diseases / drug therapy*
  • Female
  • Fibrinolysin / therapeutic use*
  • Fibrinolytic Agents / therapeutic use*
  • Focal Adhesions / drug effects*
  • Humans
  • Intravitreal Injections
  • Male
  • Middle Aged
  • Peptide Fragments / therapeutic use*
  • Retinal Diseases / diagnosis
  • Retinal Diseases / drug therapy*
  • Tomography, Optical Coherence
  • Treatment Outcome
  • Visual Acuity / physiology
  • Vitreous Body / drug effects*
  • Vitreous Body / pathology
  • Young Adult

Substances

  • Fibrinolytic Agents
  • Peptide Fragments
  • microplasmin
  • Fibrinolysin