Rizzo Stanislao, Bacherini Daniela
Dev Ophthalmol. 2017;60:160-164. doi: 10.1159/000460275. Epub 2017 Apr 20.
Vitreomacular traction (VMT) is one of many possible factors involved in the etiology of diabetic macular edema (DME). Pharmacologic vitreoretinal separation is a potential alternative to vitrectomy for VMT in diabetic retinopathy. Small case series have been published on the use of enzymatic vitreolysis in tractional DME, and demonstrate that the enzymatic release of the posterior vitreous cortex is more likely following the injection of plasmin enzyme. Further prospective and randomized clinical trials are necessary to evaluate the clinical relevance of ocriplasmin for vitreomacular traction in diabetic retinopathy, and additional studies are needed to determine more accurately which patients might benefit most from this treatment and how often and at what concentration ocriplasmin should be administered.
玻璃体黄斑牵引（VMT）是糖尿病性黄斑水肿（DME）病因中诸多可能的因素之一。药物性玻璃体视网膜分离是糖尿病视网膜病变中VMT玻璃体切除术的一种潜在替代方法。关于在牵引性DME中使用酶解玻璃体的小型病例系列已发表，表明注射纤溶酶后更有可能实现玻璃体后皮质的酶解释放。需要进一步的前瞻性和随机临床试验来评估奥克纤溶酶对糖尿病视网膜病变中玻璃体黄斑牵引的临床相关性，还需要更多研究来更准确地确定哪些患者可能从这种治疗中获益最大，以及奥克纤溶酶应多久给药一次、以何种浓度给药。
