Introduction: Unmet Medical Need

Part of the Essentials in Ophthalmology book series (ESSENTIALS)


The increasing understanding of the vitreoretinal interface’s role in the pathogenesis of disease has been evolving over the past decades. As this understanding increased, it became clear that managing the interface with medical interventions would be of benefit. To date, most management strategies involve surgical intervention in the operating room, such as vitrectomy surgery for macular hole repair. However, there is enormous opportunity to avoid surgical intervention, or intervene earlier than is appropriate currently, by utilizing pharmacologic agents to reduce or eliminate vitreoretinal adhesion. If the pharmacologic agents that lyse the vitreoretinal interface prove efficacious and safe, there is a wide array of disease or disease stages for which there currently is no reasonable intervention that might benefit. Interrupting the pathogenic evolution by safely inducing posterior vitreous detachments has potential for managing stage one macular holes and vitreo-macular traction syndrome and has possible potential in the management of age-related macular degeneration, diabetic retinopathy, and conceivably even as risk reduction before clear lens extraction with intraocular lens placement for management of myopia and presbyopia.


Visual Acuity Diabetic Retinopathy Macular Hole Diabetic Macular Edema Posterior Vitreous Detachment 
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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  1. 1.Vitreoretinal SurgeonKaiser Permanente Medical CenterBaldwin ParkUSA
  2. 2.Diabetic Retinopathy Photograph Reading CenterRegional OfficesPasadenaUSA
  3. 3.OphthalmologyUCLA Medical SchoolLos AngelesUSA
  4. 4.Clinical Trials Research and DRS Reading CenterKaiser Permanente Southern CaliforniaPasadenaUSA

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