title: Intravitreal plasmin without vitrectomy for macular edema secondary to branch retinal vein occlusion.
abstract: OBJECTIVE
  To evaluate the effects and safety of intravitreal injections of autologous plasmin enzyme (APE), without vitrectomy, as a treatment for macular edema secondary to branch retinal vein occlusion.
  
  
  METHODS
  Prospective, comparative, interventional case series.
  
  
  METHODS
  Patients were recruited and enrolled consecutively from February 1 through October 31, 2008, at the Retina Unit of the Hospital General Universitario, Valencia, Spain. An eye from 8 patients diagnosed as having macular edema due to branch retinal vein occlusion received an injection, after having received topical anesthesia, of 0.2 mL of APE, which had been obtained using a simplified method. Best-corrected visual acuity and central macular thickness measured by optical coherence tomography constitute the main outcome measures of the study.
  
  
  RESULTS
  The mean (SD) central macular thickness decreased from 494.875 (68.82) to 226.375 (28.67) μm 1 month after APE injection and to 228.570 (21.53) μm after 6 months (P < .001). The best-corrected visual acuity (logarithm of the minimal angle of resolution) improved from a preoperative value of 0.552 (0.17) to 0.217 (0.087) (mean, 20/80-20/32, Snellen equivalent) at the end of follow-up (P < .01). No secondary effects were observed during 6 months of follow-up.
  
  
  CONCLUSIONS
  This pilot study suggests that intravitreal injection of APE as a treatment for macular edema secondary to branch retinal vein occlusion improves central macular thickness and best-corrected visual acuity and may be a safe and effective alternative therapy for this condition if confirmed in controlled trials compared with standard care with longer follow-up.
authors.affiliation: Retina and Uveitis Unit, Department of Ophthalmology, Hospital La Fe de Valencia, Valencia, Spain. patyudaondo@hotmail.com
authors.forename: Patricia
authors.initials: P
authors.lastname: Udaondo
authors.forename: Manuel
authors.initials: M
authors.lastname: Díaz-Llopis
authors.forename: Salvador
authors.initials: S
authors.lastname: García-Delpech
authors.forename: David
authors.initials: D
authors.lastname: Salom
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Romero
mesh_terms: D000368:Aged; D005260:Female; D005341:Fibrinolysin / Q000008:administration & dosage*; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D005451:Fluorescein Angiography; D006801:Humans; D058449:Intravitreal Injections; D008269:Macular Edema / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D033401:Microscopy, Acoustic; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D012170:Retinal Vein Occlusion / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D041623:Tomography, Optical Coherence; D014792:Visual Acuity; D014821:Vitrectomy; D014822:Vitreous Body / Q000187:drug effects
chemical_list: D005343:Fibrinolytic Agents; D005341:Fibrinolysin