Pharmacologic Vitreolysis: Experimental Evidence
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Vitreolytic agents are characterized by their ability to induce vitreous liquefaction, separation of the posterior hyaloid, or both. Both enzymatic and nonenzymatic approaches have been tested in experimental models. While several are effective inducers of a posterior vitreous detachment, in vivo testing indicated the presence of a narrow safety profile in most tested compounds, limiting further development. The lack of a standardized methodology to assess for the presence of a PVD in both experimental and clinical settings and the inability to judge the extent of the effect makes direct comparison between compounds difficult.
This chapter reviews preclinical publicly available knowledge on known vitreolytic compounds and further discusses means of optimizing vitreolysis based on the pharmacokinetics and pharmacodynamics of ocriplasmin, the best-studied vitreolytic enzyme to date. Such optimization may require not only appropriate delivery but in certain circumstances combination with additional liquefactive agents.
KeywordsMacular Hole Diabetic Macular Edema Proliferative Diabetic Retinopathy Retinal Vein Occlusion Internal Limit Membrane
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