Macular Degeneration Clinical Trial
Official title:
Resolution of Vitreomacular Adhesion (VMA) Associated With Neovascular Age Related Macular Degeneration (AMD) With Intravitreal Microplasmin
The purpose of this study is to determine whether microplasmin given by intravitreal injection is effective and safe for the treatment of wet age-related macular degeneration (AMD) in patients who have focal vitreomacular adhesion (VMA)
The human vitreous gel undergoes progressive liquefaction with age. Concurrent with the
process of vitreous liquefaction, there is a weakening of the adhesion at the vitreoretinal
interface between the cortical vitreous gel and the inner limiting lamina. Posterior
vitreous detachment (PVD) is a separation of the cortical vitreous get from the inner
limiting lamina. PVD is usually a sudden event during which liquefied vitreous from the
center of the vitreous body bursts through a hole in the posterior vitreous cortex and then
dissects the residual cortex gel away from the inner limiting lamina. If there is residual
vitreoretinal traction around the break, this process may induce a tear in the retina that
can in turn result in rhegmatogenous retinal detachment, macular hole, or cystoid macular
edema. The importance of the vitreous in the progression of diabetic retinopathy may also
extend beyond tractional considerations. For example, it is believed that the vitreous
serves as scaffolding for new vessel formation and may also contribute to molecular
imbalances that lead to retinopathy progression. Therefore, total PVD, by releasing
vitreoretinal traction as well as other potential mechanisms, may be beneficial in various
vitreoretinal diseases such as neovascular AMD.
Vitreomacular adhesion (VMA) in exudative (wet) AMD may be associated with poor prognosis in
patients with AMD. This trial is primarily aimed at showing that release of VMA can be
induced by microplasmin, a proteolytic enzyme, in patients with wet AMD, and that
microplasmin is safe in patients w/ neovascular (wet) AMD. Secondary endpoint will be
assessment of improved AMD outcomes.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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