Ocriplasmin: A Review of Its Use in Patients with Symptomatic Vitreomacular Adhesion

Ocriplasmin (JETREA^®) is a recombinant human serine protease plasmin with proteolytic activity against the protein components (e.g. laminin, fibronectin and collagen) of the vitreous and vitreoretinal interface, thereby facilitating vitreous liquefaction and separation of vitreous from the retina. Intravitreal ocriplasmin is indicated for the treatment of symptomatic vitreomacular adhesion (USA) and vitreomacular traction including when associated with a macular hole of diameter ≤400 μm in adult patients (EU). The efficacy of ocriplasmin at the recommended dose of a single 125 μg intravitreal injection was demonstrated in two well-designed pivotal phase III trials of virtually identical design (TG-MV-006 and TG-MV-007) in patients with symptomatic vitreomacular adhesion. A significantly greater proportion of patients treated with ocriplasmin than those treated with placebo achieved nonsurgical resolution of vitreomacular adhesion at day 28 (primary endpoint), with the significant between-group difference sustained until study end (month 6). At day 28, the proportion of eyes achieving total posterior vitreous detachment or nonsurgical closure of macular holes was also significantly greater with ocriplasmin than with placebo. Ocriplasmin was generally well tolerated in these trials, with most ocular adverse events being mild in severity and transient in nature. Current evidence suggests that ocriplasmin is a useful treatment option for patients with symptomatic vitreomacular adhesion.