![]() A range of positive predictive factors have now been reported including age less than 65 years (odds ratio (OR) 2.7), phakic eyes (OR: 3.0), adhesion diameter <1500 μm (OR: 7.9), and absence of epiretinal membrane (ERM) (OR: 4.8). Indeed, although the evidence behind the efficacy of OCP is comprehensive, there still remains a significant variability in the reported success rate (range 0–71% ) which is thought to be largely due to case mix. One is the relatively low and variable success rate in achieving VMT release of around 30–40%, compared to vitrectomy at ~100%. The question therefore arises whether this apparent step away from the use of OCP is warranted or should we be both offering and using this evidence-based treatment more often?Ī number of factors have potentially influenced the low uptake of OCP. ![]() This reported a high-certainty of evidence that the drug successfully released vitreous adhesion and closed macular holes. This would seem to contradict the findings of the 2017 Cochrane Review on the use of OCP. A survey of 117 members at the 2017 British and Eire Association of Vitreoretinal Surgeons (BEAVRS) meeting revealed only seven (6%) would initially opt for OCP in the treatment of symptomatic VMT. More recently the use of OCP has waned and it now seems to be rarely offered as a treatment option. The efficacy of OCP was demonstrated in two phase three clinical trials (the MIVI-TRUST study group) and there was significant interest in the drug in the initial years following its approval by NICE. ![]() Ocriplasmin (OCP) is a truncated recombinant form of human plasmin and was first approved for use in the UK by the National Institute for Health and Care Excellence (NICE) in 2013 for adults with symptomatic VMT, including when associated with a FTMH. ![]()
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