Ocriplasmin用于治疗玻璃体黄斑牵引(VMT),有或没有全厚度黄斑孔(MH)。我们系统地回顾了ocriplasmin对玻璃体黄斑粘连分辨率(VMAR)的影响的证据,MH闭合,玻璃体切除术,和最佳矫正视力(BCVA),并研究了基线协变量对结局的影响。我们将个体参与者数据荟萃分析应用于整个人群和由MH或视网膜前膜(ERM)存在定义的亚组。将安全性数据汇总并制成表格。纳入5项随机对照试验(1,067名参与者)。治疗6个月后,与对照相比,ocrilasmin实现了更高的VMAR和MH闭合率,降低了玻璃体切除术的几率,并增加≥10个字母的BCVA增加的可能性。当ERM,宽VMA(>1500µm),糖尿病视网膜病变,在年轻的参与者中存在或假晶状体眼,女人,和MHs的眼睛。Ocriplasmin治疗的参与者经历了更多的短期视力障碍,不能预测最终的BCVA,以及玻璃体漂浮物,验光,畏光,眼睛疼痛,视力模糊,和色盲。最常见的严重不良事件为ocrilasmin和对照,分别,MH进展(22.5%,17.3%),新MH(1.5%,3.4%)和视网膜脱离(0.8%,1.2%)。Ocriplasmin促进VMAR和MH闭合。瞬态视觉现象并不少见。
Ocriplasmin is used to treat vitreomacular traction (VMT), with or without full-thickness macular hole (MH). We systematically reviewed the evidence on ocriplasmin\'s effect on vitreomacular adhesion resolution (VMAR), MH closure, vitrectomy, and best-corrected visual acuity (BCVA) and investigated the effect of baseline covariates on outcome. We applied individual participant data meta-analyses to the entire population and to subgroups defined by MH or epiretinal membrane (ERM) presence. Safety data were pooled and tabulated. Five randomized controlled trials (1,067 participants) were included. Six months after treatment, ocriplasmin achieved higher rates of VMAR and MH closure versus control, lowered vitrectomy odds, and increased the likelihood of a ≥10-letter BCVA increase. VMAR rates were lower when ERM, broad VMA (> 1500 µm), diabetic retinopathy, or pseudophakia were present and higher in younger participants, women, and eyes with MHs. Ocriplasmin-treated participants experienced more short-term visual impairment that was not predictive of final BCVA, as well as vitreous floaters, photopsia, photophobia, eye pain, blurred vision, and dyschromatopsia. The most common serious adverse events for ocriplasmin and control, respectively, were MH progression (22.5%, 17.3%), new MH (1.5%, 3.4%) and retinal detachment (0.8%, 1.2%). Ocriplasmin promotes VMAR and MH closure. Transient visual phenomena are not uncommon.