Ocriplasmin

Summary

Ocriplasmin (Jetrea) is an intravitreal injection approved for the treatment of symptomatic vitreomacular adhesion (VMA) including macular holes ≤400 µm in adults. It offers a non-surgical alternative to vitrectomy by enzymatically dissolving vitreoretinal adhesions.

Mechanism of Action

Ocriplasmin is a recombinant truncated form of human plasmin with proteolytic activity against fibronectin and laminin, key components of the vitreoretinal interface. It dissolves the protein matrix that adheres the vitreous to the retina, facilitating pharmacologic vitreolysis and resolution of vitreomacular adhesion (VMA) and small macular holes.

Routes of Administration

Goals & Uses

• Pharmacologic vitreolysisOphthalmic / VitreoretinalHigh
• Resolution of symptomatic vitreomacular adhesion (VMA)Ophthalmic / VitreoretinalHigh
• Non-surgical closure of macular holes ≤400 µmOphthalmic / VitreoretinalHigh

Contraindications

• History of rhegmatogenous retinal detachmentOcular ConditionHigh
• Large macular holes (>400 µm)AnatomicalHigh
• Exudative age-related macular degenerationOcular ConditionModerate
• Proliferative diabetic retinopathyOcular ConditionHigh
• High myopia (axial length >26 mm or refractive error > -8 diopters)Ocular ConditionModerate

Adverse Effects

• Transient decreased visual acuityOcularCommon
• Retinal detachmentOcularUncommon
• Dyschromatopsia (color vision changes)OcularUncommon
• Photopsia (flashes of light)OcularCommon
• Macular hole enlargementOcularUncommon
• Vitreous floatersOcularCommon

Drug Interactions

• Anti-VEGF agents (e.g., ranibizumab, bevacizumab)Low

Population Constraints

• Pediatric patientsAgeRelative
• Patients with lens zonule weaknessOcular ConditionRelative
• Pregnant womenReproductiveRelative

Regulatory Status

• European UnionApprovedApproved: Symptomatic vitreomacular adhesion (VMA) including when associated with macular hole of diameter ≤400 µmEMA approved March 2013; centralized procedure.
• United StatesApprovedApproved: Symptomatic vitreomacular adhesion (VMA)FDA approved October 2012 (NDA 125422); marketed as Jetrea by ThromboGenics/DORC.
• United KingdomApprovedApproved: Symptomatic vitreomacular adhesionApproved following EU approval; post-Brexit regulatory status maintained via MHRA.

Approved by the FDA in October 2012 and by the EMA in 2013. Single-dose intravitreal injection of 125 µg in 0.1 mL. Administered by an ophthalmologist.

Evidence & Sources

No sources recorded yet.