Medical management of vitreoretinal interface disorders

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Year 2013 will be a cornerstone in the history of therapeutic vitreolysis with the European approval of the ocriplasmine in March, the first commercially available product to achieve in some selected cases a separation of the vitreo-retinal interface. Since the publication in 1993 of the first vitreous detachments in rabbit eyes, obtained by intravitreal injection of plasmine, the road has been opened to several researches looking for the best candidate to produce this detachment in human eyes. The published data of the use of ocriplasmine to date are still too fragmentary to give a precise idea of what could be the best indications to perform an intravitreal injection of drug instead of a classical vitrectomy. Aside the symptomatic vitreo-macular tractions syndrome and small idiopathic macular holes, some other disorders in which an abnormal vitréo-retinal adhesion seems to play a role are currently evaluated, such as the early stages of macular degeneration and diabetic macular edemas. We’ll present the last available data, focusing beyond the pure scientific results, on the possible consequences on our everyday surgical practice and the clinical decision tree in vitreo-retinal disorders.

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