What is Ocriplasmin: Uses, Dosage, Side Effects and More

Ocriplasmin is a specialized eye injection that helps treat a specific condition called vitreomacular adhesion. This medication works by dissolving the abnormal connection between two parts of your eye - the vitreous gel and the macula (the part of your retina responsible for sharp, central vision).

If your doctor has recommended ocriplasmin, you're likely dealing with vision changes that affect your daily activities. This treatment represents a significant advancement in eye care, offering a less invasive alternative to traditional eye surgery for certain patients.

What is Ocriplasmin?

Ocriplasmin is an enzyme-based medication that's injected directly into your eye to treat vitreomacular adhesion. It's a purified protein that works like molecular scissors, carefully breaking down the proteins that create unwanted connections in your eye.

The medication comes from a larger enzyme called plasmin, which your body naturally produces. Scientists have modified this enzyme to make it more targeted and effective for treating specific eye conditions. Think of it as a precision tool designed specifically for delicate eye tissue.

This treatment is relatively new in the world of eye care, having been approved by the FDA in 2012. It's sold under the brand name Jetrea and represents a major breakthrough for people who previously had limited treatment options.

What is Ocriplasmin Used For?

Ocriplasmin treats vitreomacular adhesion, a condition where the gel-like substance in your eye (vitreous) sticks abnormally to your macula. This unwanted connection can cause vision problems, including blurred or distorted central vision.

Your doctor might recommend this treatment if you're experiencing symptoms like straight lines appearing wavy, difficulty reading, or problems with detailed tasks. The condition typically affects people over 65, though it can occur at any age.

In some cases, ocriplasmin can also help with small macular holes - tiny tears in the macula that can significantly impact your central vision. However, it's most effective for holes smaller than 400 micrometers in diameter.

How Does Ocriplasmin Work?

Ocriplasmin works by breaking down specific proteins that hold the vitreous gel to your macula. It targets proteins called fibronectin and laminin, which are the main culprits creating this abnormal adhesion.

Once injected into your eye, the medication begins working within hours to days. It essentially dissolves the molecular "glue" that's causing the problem, allowing your vitreous to separate naturally from the macula. This process is called vitreous detachment.

The medication is considered moderately strong for eye treatments. It's powerful enough to create the desired separation but gentle enough to avoid damaging surrounding healthy tissue. Most patients see improvement within a few weeks, though some may notice changes sooner.

How Should I Take Ocriplasmin?

Ocriplasmin is given as a single injection directly into your eye by an eye specialist (ophthalmologist or retinal specialist). This procedure is called an intravitreal injection and takes place in your doctor's office or an outpatient surgery center.

Before the injection, your doctor will clean the area around your eye and apply numbing drops to minimize discomfort. They may also give you antibiotic drops to prevent infection. The actual injection takes only a few seconds, though the entire appointment may last 30-60 minutes.

You don't need to fast before the procedure, and you can eat normally beforehand. However, you should arrange for someone to drive you home, as your vision may be temporarily blurry or uncomfortable after the injection.

After the injection, your doctor will likely prescribe antibiotic eye drops to use for several days. They'll also schedule follow-up appointments to monitor your progress and ensure the treatment is working effectively.

How Long Should I Take Ocriplasmin For?

Ocriplasmin is typically given as a single injection, and most patients don't need repeat treatments. The medication continues working in your eye for several weeks after the injection, gradually dissolving the abnormal adhesion.

Your doctor will monitor your progress through regular eye exams over the following months. These appointments usually occur at one week, one month, and three months after injection. Some patients may need additional follow-ups depending on their response to treatment.

If the first injection doesn't achieve the desired results after three months, your doctor might discuss alternative treatments. However, repeat injections of ocriplasmin are uncommon, as the medication either works within the first few months or alternative approaches are considered.

What Are the Side Effects of Ocriplasmin?

Most people experience some mild side effects after ocriplasmin injection, which is completely normal as your eye adjusts to the treatment. Understanding what to expect can help you feel more prepared and less anxious about the process.

Common side effects you might experience include:

• Temporary eye pain or discomfort (usually mild and resolves within a few days)
• Seeing small floating spots or "floaters" in your vision
• Temporary blurry vision or haziness
• Mild eye redness or irritation
• Sensitivity to light for a few days
• Feeling like something is in your eye

These common effects typically improve within a week and are signs that your eye is responding to the treatment. Your doctor will provide specific instructions on managing any discomfort.

More serious side effects are less common but require immediate medical attention. These rare complications can include:

• Severe eye pain that doesn't improve with over-the-counter pain relievers
• Sudden, significant vision loss
• Flashing lights or sudden increase in floaters
• Signs of infection such as increased redness, discharge, or fever
• Retinal detachment (affects less than 1% of patients)
• Significant increase in eye pressure

While these serious complications are rare, it's important to contact your doctor immediately if you experience any of these symptoms. Quick treatment can prevent permanent vision problems.

Who Should Not Take Ocriplasmin?

Ocriplasmin isn't suitable for everyone with vitreomacular adhesion. Your doctor will carefully evaluate your specific condition to determine if you're a good candidate for this treatment.

You should not receive ocriplasmin if you have:

• An active eye infection or inflammation
• Large macular holes (greater than 400 micrometers)
• High myopia (severe nearsightedness) with associated retinal changes
• Recent eye surgery or trauma
• Certain retinal diseases that affect the macula
• Proliferative diabetic retinopathy with active blood vessel growth

Your doctor will also consider your overall health and other medications you're taking. While ocriplasmin is injected directly into the eye, it's important to discuss your complete medical history to ensure the treatment is safe for you.

Pregnant and breastfeeding women should discuss the risks and benefits with their doctor, as there's limited information about ocriplasmin's effects during pregnancy and nursing.

Ocriplasmin Brand Name

Ocriplasmin is sold under the brand name Jetrea in the United States and many other countries. This is the only commercially available form of ocriplasmin for treating vitreomacular adhesion.

Jetrea is manufactured by Oxurion (formerly ThromboGenics), a Belgian pharmaceutical company specializing in eye treatments. The medication comes in a single-use vial containing 0.1 mL of solution.

Your doctor may refer to the medication by either name - ocriplasmin or Jetrea - but they're the same medication. The brand name is often used in medical settings and insurance documentation.

Ocriplasmin Alternatives

If ocriplasmin isn't suitable for your condition or doesn't provide the desired results, several alternative treatments are available. Your doctor will help you understand which option might work best for your specific situation.

The main alternative is vitrectomy, a surgical procedure where your surgeon removes the vitreous gel from your eye and replaces it with a saline solution. This surgery is more invasive than ocriplasmin injection but has a higher success rate for treating vitreomacular adhesion.

For some patients, careful observation might be appropriate, especially if symptoms are mild. Many cases of vitreomacular adhesion resolve on their own over time without any treatment.

Other medications are being researched for similar conditions, but ocriplasmin remains the only FDA-approved pharmaceutical treatment for vitreomacular adhesion. Your retinal specialist can discuss which approach makes the most sense for your particular case.

Is Ocriplasmin Better Than Vitrectomy Surgery?

Ocriplasmin and vitrectomy surgery each have distinct advantages, and the best choice depends on your specific condition and preferences. Neither treatment is universally better - they serve different patients and situations.

Ocriplasmin offers several benefits as a less invasive option. The injection procedure takes only minutes, doesn't require general anesthesia, and has a shorter recovery time. You can typically return to normal activities within a few days, and there's no risk of cataract formation, which can occur after vitrectomy.

However, vitrectomy surgery has a higher success rate, working in about 90-95% of cases compared to ocriplasmin's 25-40% success rate. Surgery also allows your doctor to address other eye problems simultaneously and provides more predictable results.

Your doctor will consider factors like the size of any macular hole, the strength of the vitreomacular adhesion, your age, and your overall health when recommending treatment. Many doctors try ocriplasmin first when appropriate, as it's less invasive and can potentially avoid the need for surgery.