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Randomized Control Trial Summary

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Peter Stalmans and associates143 conducted a randomized control trial. Its data support the finding that intravitreal injection of ocriplasmin leads to resolution of vitreomacular traction, induction of posterior vitreous detachment, and closure of a macular hole in some cases. The incidence of vitrectomy was lower among the patients who received ocriplasmin than among those who received placebo. A sham injection would have provided a better comparison with the natural history of the disease process than that provided by the group of patients who received a placebo, which was chosen to control for the effect of an intravitreal injection. The main visual symptom of vitreomacular traction and macular holes is decreased visual acuity. Although more…show more content…
Vitreous manipulation effected through intravitreal injection may occasionally result in a posterior vitreous detachment,213,214 in which case, the placebo injection of 0.1 ml may have induced some treatment response. The superior therapeutic effects of the ocriplasmin injection would then be indicative of an additional biologic effect of enzymatic vitreolysis over placebo. The applicability of this study is limited by the exclusion of patients with severe myopia, aphakia, proliferative diabetic retinopathy, or neovascular age-related macular degeneration.215 Further studies will be needed to explore the effect of enzymatic vitreolysis in these diseases. In conclusion, the study shows that enzymatic vitreolysis represents a mean to resolve vitreomacular traction and to close macular holes. Intravitreal injection of ocriplasmin was superior to injection of placebo in altering the vitreoretinal interface of affected eyes, although it was accompanied by some, mainly transient, ocular adverse
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