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Chemical vitreolysis

Thesis

Last updated: 06 Feb 2023

Subjects

-

Tags

Ophthalmology

Advisors

El-Zhawahri, Aumar , El-Mekkawi, Hani

Authors

Yousuf, Muhib Mussttafa

Accessioned

2017-07-12 06:42:09

Available

2017-07-12 06:42:09

type

M.Sc. Thesis

Abstract

Introduction, pharmacologic vitreolysis is an emerging therapeutic modality intended to mitigate anomalous PVD by chemically altering vitreous structure and weakening vitreoretinal adhesion to safely detach the posterior vitreous.Age related vitreous degeneration, during aging , substantial alterations take place in the vitreous body . Beginning after the fourth decade of life , there is a significant decrease in the gel volume and an increase in the liquid volume of human vitreous .Pharmacological vitreolysis, in recent years, the importance of vitreous in the pathogenesis of various retinopathies has been increasingly appreciated, and vitreous is being treated with therapeutic modalities, for the most part surgical. The future, however, will see an increase in the use of agents for therapy and prevention. Such pharmacologic therapies depend upon a good understanding of the biochemical composition and organization of vitreous, how this structure changes with age ,and how anomalies in normal aging and systemic diseases lead to vitreoretinal disorders .Summary, the field of pharmacologic vitreolysis or, more descriptively, nonsurgically induced PVD, is growing. Numerous agents for this purpose have been studied with variable success such as dispase, collagenase, hyaluronidase, chondroitinase, plasmin, and microplasmin. Of these, hyaluronidase, plasmin, and microplasmin seem to have the most favorable profile. Whereas hyaluronidase has been shown to cause liquefaction of the vitreous without induction of a PVD, Plasmin and microplasmin cause vitreous liquefaction and induction of a PVD in some patients . At present, microplasmin is furthest along in clinical research and development. A phase I/II clinical trial of microplasmin as a surgical adjuvant to facilitate intraoperative peeling of the cortical vitreous has been completed and suggests favorable results . A phase III clinical trial of microplasmin as an in-office alternative to surgical vitrectomy is underway.

Issued

1 Jan 2010

DOI

http://dx.doi.org/10.21473/iknito-space/37610

Details

Type

Thesis

Created At

28 Jan 2023