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THE microplasmin, OPTION FOR SURGERY vitreoretinal tractions

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A recent article of Ophthalmology Europe Times reviews the potential of microplasmin in the treatment of vitreoretinal traction, especially in vitreomaculares adhesions, which may give rise to significant risk for central vision and often require vitreo-retinal surgery for recovery.

The microplasmin is a proteolytic enzyme developed by Trombogenics , and according to clinical studies can facilitate and induce a posterior vitreous detachment (PVD) by enzymatic breakdown of proteins that maintain adhesion between vitreous and retina. Could thus replace, in certain cases, a vitrectomy surgery, and even could have potential applications in the accessions of diabetic macular edema, diabetic retinopathy and macular degeneration associated with age.

According to the study conducted by Trombogenics, currently in phase III, the microplasmin is effective to break the adhesions vitreomaculares, improves vision in patients without surgery, can be applied in macular holes, is safe and well tolerated.

pilot study results presented by Professor Peter Stalmans in Congress EURETINA of Paris showing improvement at 6 months of treatment, at least 2 lines in 23.7% of patients treated with microplasmin , and 3 lines at 9.7%.

We recall the editorial of Drs Cervera Diaz-Llopis and in the Journal Archives of the English Society of Ophthalmology in August 2007 titled "posterior vitreous detachment and pharmacological vitreolysis: the new age of vitrectomy enzyme 'esp Arch Ophthalmol Soc V.82 n.8.

In his simple but magnificent exhibition, our colleagues exposed the "universally known and perverse effect of strong vitreo-retinal adhesions": 1) Recurrence of detachment of retina with or without vitreoretinal proliferation. 2) detachment of retina diseases glassy-organized with Stickler syndrome, etc .- 3) Bilateralization of giant tears 4) Persistence and chronicity of macular edema (diabetic, venous occlusion, uveitis, pseudophakic Irvine-Gass syndrome). 5) myopic macular traction syndrome. 6) macular epiretinal membrane 6) Emergence of macular holes and their progression from incomplete to complete. 7) progression of proliferative diabetic retinopathy by vitreous traction of the new vessels. " And then spoke of the "gracious" and "prophylactic effect of having the DPV as soon as possible, and these should have parted ways before a slow, gradual and controlled, but without any risk of lamellar macular hole or complete, or cystoid macular edema.

Even then made reference to various drugs proteoíticos with ability to accelerate vitreous liquefaction, such as dispase, hyaluronidase (VITROS ®) , chondroitinase, tissue plasminogen activator, urokinase, streptokinase, natokinasa (NAT Substilin ®) , collagenase, plasmin and microplasmin (Trombogenic ®) and sentences "If this method gets to develop clinically, ie get off and liquefy the vitreous with a single intravitreal injection can be in a not too distant future to a major paradigm shift from our current conception of vitreous surgery today to have known: the birth of enzymatic vitrectomy . "

http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0365-66912007000800001&nrm=iso&tlng=pt

CEUTA EYES. INNOVATION IN OPHTHALMOLOGY.
EYE CENTER DR. CATOIRA MEDIN

Eyes Ceuta - Innovating Ophthalmology Ophthalmology Center Dr. Medín Catoira