Macular Hole Medication

Updated: Aug 28, 2018
  • Author: Kean Theng Oh, MD; Chief Editor: Douglas R Lazzaro, MD, FAAO, FACS  more...
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Medication

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. [7] 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. [34] Multiple case reports have also evaluated individual patients with ancillary studies such as electroretinography and perimetry. [35] Fahim et al suggest that the retinal dysfuction associated with ocriplasmin may be related to the enzymatic cleavage of intraretinal laminin. [36] Subretinal deposits have also been reported following successful release of vitreomacular traction. [37]

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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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