title: From the analysis of pharmacologic vitreolysis to the comprehension of ocriplasmin safety.
abstract: BACKGROUND
  Pharmacologic vitreolysis is a strategy used to treat anomalous posterior vitreous detachment, by weakening vitreoretinal adhesion with an intravitreal drug. Pharmacologic vitreolysis facilitates surgery, and abnormalities of the vitreoretinal interface including vitreomacular traction (VMT) and early stage macular hole (MH) could be resolved. Ocriplasmin is a recombinant protease, active against fibronectin and laminin, which are important components of the vitreoretinal interface. Ocriplasmin has been approved for symptomatic treatment of VMT and MH with visible traction, and it functions by dissolving the proteins that link the vitreous to the macula, thereby creating a complete posterior vitreous detachment (PVD).
  
  
  METHODS
  This paper reviews the current knowledge and status of investigations regarding the use of ocriplasmin for pharmacologic vitreolysis and its safety.
  
  
  CONCLUSIONS
  Ocriplasmin is a non-specific enzyme; therefore, it dissolves vitreal proteins as well as possibly proteins associated with visual function in the retina, choroid, and lens. Ocular adverse events (OAEs) of ocriplasmin include transient visual loss, intraocular inflammation, vitreous floaters, lens opacification, zonular instability of the lens, and intraocular hemorrhage. The prevalence of the OAEs is very low; however, on rare occasions, they can result in widespread retinal dysfunction. Research into the acute and long-term safety of ocriplasmin is required.
authors.affiliation: a Ophthalmology Clinic, Spedali Civili di Brescia, Department of Medical and Surgical Specialties, Radiological Specialties and Public Health , University of Brescia , Brescia , Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Morescalchi
authors.affiliation: a Ophthalmology Clinic, Spedali Civili di Brescia, Department of Medical and Surgical Specialties, Radiological Specialties and Public Health , University of Brescia , Brescia , Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Gambicorti
authors.affiliation: a Ophthalmology Clinic, Spedali Civili di Brescia, Department of Medical and Surgical Specialties, Radiological Specialties and Public Health , University of Brescia , Brescia , Italy.
authors.forename: Sarah
authors.initials: S
authors.lastname: Duse
authors.affiliation: b Ophthalmology Clinic, Department of Health Science , University of Molise , Campobasso , Italy.|c Istituto Neurologico Mediterraneo, I.R.C.C.S Neuromed , Pozzilli ( Isernia ), Italy.
authors.forename: Ciro
authors.initials: C
authors.lastname: Costagliola
authors.affiliation: a Ophthalmology Clinic, Spedali Civili di Brescia, Department of Medical and Surgical Specialties, Radiological Specialties and Public Health , University of Brescia , Brescia , Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Semeraro
mesh_terms: D000818:Animals; D005341:Fibrinolysin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D058449:Intravitreal Injections; D010446:Peptide Fragments / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D012160:Retina / Q000187:drug effects / Q000473:pathology; D012167:Retinal Perforations / Q000188:drug therapy; D000267:Tissue Adhesions / Q000473:pathology; D016896:Treatment Outcome; D014822:Vitreous Body / Q000187:drug effects*; D020255:Vitreous Detachment / Q000188:drug therapy*
chemical_list: D010446:Peptide Fragments; C054561:microplasmin; D005341:Fibrinolysin
keywords: Macular hole; ocriplasmin; pharmacologic vitreolysys; safety; vitreo-macular traction