基因重组纤溶酶ocriplasmin治疗玻璃体黄斑粘连的研究进展

摘要

玻璃体黄斑界面异常与多种黄斑疾病的发生和发展密切相关,目前主要的治疗方法是通过玻璃体切割术解除异常的玻璃体视网膜粘连,尤其是对黄斑的牵拉.由于玻璃体切割术的并发症及自身限制,人们一直致力于药物性玻璃体后脱离(PVD)的研究,其中以基因重组纤溶酶ocriplasmin最受关注.大量的实验研究及临床试验表明,玻璃体腔内注射ocriplasmin能形成完整的PVD,解除玻璃体黄斑粘连,在相关疾病的治疗上有广阔的应用前景.就ocriplasmin治疗玻璃体黄斑粘连的机制、药代动力学、实验和临床研究评估及不良反应的研究进展进行综述.%Vitreous retinal interface abnormalities are associated with many macular diseases.The main approach of treatment is to release the vitreomacular adhesion with pars plana vitrectomy.Because of its complication and limitation,researches of pharmacologic posterior vitreous detachment (PVD) were undertaken.Gene recombinant ocriplasmin was proved by several experiments and clinical trials by inducing a complete PVD,showing its promising prospect.This article reviewed the literatures of ocriplasmin,including pathobiology in treatment of vitreomacular adhesion,pharmacokinetics,vitreodynamics,experimental studies and clinical trials and adverse events.