Pharmacologic vitreolysis with ocriplasmin: Clinical studies

Abstract

The natural vitreous aging process involves liquefaction of the gel and separation of the posterior vitreous cortex from the retina [1–3] [see chapter II.C. Aging and PVD]. In some eyes, however, the adhesion between the vitreous cortex and the macular surface does not weaken sufficiently to allow complete posterior vitreous detachment (PVD), leading to persistent attachment at the macular surface, or vitreomacular adhesion (VMA) [see chapter III.B. Anomalous PVD and vitreoschisis]. The diagnosis of VMA is based on the analysis of optical coherence tomography (OCT) imaging and is, by definition, an asymptomatic non-pathologic state. Persistent VMA can progress to pathologic conditions, such as vitreomacular traction (VMT), that disturb the vitreomacular interface (VMI) and can cause visual symptoms. A classification system of VMA, VMT, and full-thickness macular holes has been developed by an international consensus panel [see chapter III.D. Vitreo-macular raction and holes]. For objectivity and uniformity, this system is based on findings and not symptoms.