Intravitreal Injection of Autologous Plasmin Enzyme for Macular Edema Associated with Branch Retinal Vein Occlusion.
Summary of "Intravitreal Injection of Autologous Plasmin Enzyme for Macular Edema Associated with Branch Retinal Vein Occlusion."
PURPOSE:
To investigate the effects of an intravitreal injection of autologous plasmin enzyme for macular edema associated with a branch retinal vein occlusion (BRVO).
DESIGN:
Prospective, interventional case studies.
METHODS:
Twenty-six eyes of 26 patients (14 men and 12 women) with macular edema resulting from a BRVO were studied. None of the eyes had a posterior vitreous detachment (PVD). The average age at the onset of BRVO was 58.7 +/- 6.6 years. The interval between onset of the macular edema and injection of autologous plasmin enzyme was 4.2 months. One international unit of autologous plasmin enzyme in 0.1 mL was injected into each vitreous. The presence of a PVD was evaluated 1 week after the injection, and the visual acuity and macular thickness were measured before and 1 week and 1, 3, 6, and 12 months after the autologous plasmin enzyme injection.
RESULTS:
After the autologous plasmin enzyme injection, a total PVD was observed in 23 eyes and no PVD was observed in 3 eyes. The visual acuity gradually recovered after the injection, improved by 2 lines or more in 23 eyes, and remained unchanged in the 3 eyes. The retinal thickness also recovered gradually at 1, 3, 6, and 12 months. The mean retinal thickness was reduced from 602.12 to 253.62 mum at 12 months after surgery. It was reduced significantly after 1, 3, 6, and 12 months (P < .0001).
CONCLUSIONS:
Intravitreal autologous plasmin enzyme may lead to an improvement of visual acuity and a reduction of macula edema in eyes with BRVO.
Affiliation
Department of Ophthalmology, Juntendo University, Urayasu Hospital, Chiba, Japan.
Journal Details
This article was published in the following journal.
Name: American journal of ophthalmology
ISSN: 1879-1891
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20801424
- DOI: http://dx.doi.org/10.1016/j.ajo.2010.06.005
Medical and Biotech [MESH] Definitions
Macular Edema
Fluid accumulation in the outer layer of the MACULA LUTEA that results from intraocular or systemic insults. It may develop in a diffuse pattern where the macula appears thickened or it may acquire the characteristic petaloid appearance referred to as cystoid macular edema. Although macular edema may be associated with various underlying conditions, it is most commonly seen following intraocular surgery, venous occlusive disease, DIABETIC RETINOPATHY, and posterior segment inflammatory disease. (From Survey of Ophthalmology 2004; 49(5) 470-90)
Geographic Atrophy
A form of MACULAR DEGENERATION also known as dry macular degeneration marked by occurrence of a well-defined progressive lesion or atrophy in the central part of the RETINA called the MACULA LUTEA. It is distinguishable from WET MACULAR DEGENERATION in that the latter involves neovascular exudates.
Alpha-2-antiplasmin
A member of the serpin superfamily found in plasma that inhibits the lysis of fibrin clots which are induced by plasminogen activator. It is a glycoprotein, molecular weight approximately 70,000 that migrates in the alpha 2 region in immunoelectrophoresis. It is the principal plasmin inactivator in blood, rapidly forming a very stable complex with plasmin.
Intravitreal Injections
The administration of substances into the VITREOUS BODY of the eye with a hypodermic syringe.
Blood Patch, Epidural
The injection of autologous blood into the epidural space either as a prophylactic treatment immediately following an epidural puncture or for treatment of headache as a result of an epidural puncture.
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