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Macular Hole Medication

  • Author: Kean Theng Oh, MD; Chief Editor: Hampton Roy, Sr, MD  more...
 
Updated: Apr 21, 2016
 

Medication Summary

The first protease to treat vitreomacular adhesions associated with macular hole was approved by the FDA in October 2012. Nonsurgical closure of the macular hole was shown in 40.6% of patients treated with an intravitreal injection of ocriplasmin compared with 10.6% who received placebo.[6] However, there is evidence of potential retinal toxicity associated with the use of ocriplasmin. Anatomic changes in the outer segments were seen in 7 of 17 patients reported in a series by Singh et al.[22] Multiple case reports have also evaluated individual patients with ancillary studies such as electroretinography and perimetry.[23] Fahim et al suggest that the retinal dysfuction associated with ocriplasmin may be related to the enzymatic cleavage of intraretinal laminin.[24]

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Ophthalmic, Other

Class Summary

Protease enzymes provide a nonsurgical treatment method for vitreomacular adhesion.

Ocriplasmin intravitreal (Jetrea)

 

Elicits proteolytic activity against protein components within the vitreous body and vitreoretinal interface (eg, laminin, fibronectin, collagen), thereby dissolving the protein matrix responsible for vitreomacular adhesion.

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Contributor Information and Disclosures
Author

Kean Theng Oh, MD Consulting Staff, Associated Retinal Consultants, PC

Kean Theng Oh, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Ophthalmology, American Society of Retina Specialists, Association for Research in Vision and Ophthalmology, Michigan Society of Eye Physicians & Surgeons

Disclosure: Nothing to disclose.

Coauthor(s)

John H Drouilhet, MD, FACS Clinical Professor, Department of Surgery, Section of Ophthalmology, University of Hawaii, John A Burns School of Medicine

John H Drouilhet, MD, FACS is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, American Medical Association

Disclosure: Nothing to disclose.

Neal H Atebara, MD Private Practice, Retina Center of Hawaii

Neal H Atebara, MD is a member of the following medical societies: American Academy of Ophthalmology, American Society of Retina Specialists, Retina Society, American Medical Association, Hawaii Medical Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Simon K Law, MD, PharmD Clinical Professor of Health Sciences, Department of Ophthalmology, Jules Stein Eye Institute, University of California, Los Angeles, David Geffen School of Medicine

Simon K Law, MD, PharmD is a member of the following medical societies: American Academy of Ophthalmology, Association for Research in Vision and Ophthalmology, American Glaucoma Society

Disclosure: Nothing to disclose.

Steve Charles, MD Director of Charles Retina Institute; Clinical Professor, Department of Ophthalmology, University of Tennessee College of Medicine

Steve Charles, MD is a member of the following medical societies: American Academy of Ophthalmology, American Society of Retina Specialists, Macula Society, Retina Society, Club Jules Gonin

Disclosure: Received royalty and consulting fees for: Alcon Laboratories.

Chief Editor

Hampton Roy, Sr, MD Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences

Hampton Roy, Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, Pan-American Association of Ophthalmology

Disclosure: Nothing to disclose.

Additional Contributors

Brian A Phillpotts, MD, MD 

Brian A Phillpotts, MD, MD is a member of the following medical societies: American Academy of Ophthalmology, American Diabetes Association, American Medical Association, National Medical Association

Disclosure: Nothing to disclose.

Acknowledgements

Bradley M Hughes, MD Assistant Professor, Department of Ophthalmology, Retina and Vitreous Service, University of Arkansas for Medical Sciences

Bradley M Hughes, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Ophthalmology

Disclosure: Nothing to disclose.

Sherman O Valero, MD Consulting Staff, Department of Ophthalmology, Makati Medical Center, Philippines

Disclosure: Nothing to disclose.

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Full-thickness macular hole showing a surrounding cuff of subretinal fluid.
Full-thickness macular hole with typical yellowish granular deposits on the retinal pigment epithelium.
Fluorescein angiogram showing a central window defect.
Preoperative fundus photograph of a macular hole.
Fundus photograph of the same patient as in the image above at 6 months postoperatively. Note the increased media opacity caused by cataractous changes of the lens.
Fundus photograph of a stage 1a macular hole with characteristic yellow spot at the center of the fovea.
 
 
 
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