Introduction

Ocriplasmin (trade name: Jetrea) has been approved in Germany since March 2013 for the treatment of vitreomacular traction (VMT) in adults, an eye disorder that is usually age-related. The drug is also an option if the condition has caused a small hole to form in the retina.

As people age, the vitreous body of the eye (the clear gel that fills the space between the lens and the retina) shrinks and starts to detach from the retina (the lining of the back of the eye). This usually goes unnoticed, without vision being affected.

In vitreomacular traction, the retina near the point of sharpest vision (macula) remains only partly attached to the vitreous body. The retina becomes deformed as a result, which sometimes causes it to rip. This leads to blurred or distorted vision, or even loss of vision.

If visual impairment is too severe, a certain type of eye surgery (vitrectomy) is an option. This involves removing the vitreous body and repairing the retina as much as possible.

Ocriplasmin is an enzyme that can dissolve the “glue” between the vitreous body and the retina. This is done to reduce the “pulling force” on the retina – allowing it to return to a normal shape – and to avoid the need for vitrectomy.

Application

Ocriplasmin is injected once into the vitreous body of the eyeball by an ophthalmologist (eye doctor). One injection contains 0.125 mg of the drug. After the injection, patients should be monitored for one hour to check for any side effects.

If both eyes are to be treated, the second injection should be given at least seven days later.

Other treatments

For people with vitreomacular traction who have severe symptoms, surgery to remove the vitreous body (vitrectomy) is an option. Problems such as increasingly blurred vision or the changes in the retina progressing are considered to be severe symptoms.

If the symptoms are mild, such as slightly impaired vision, and if the condition doesn’t progress, regular eye check-ups are usually enough (watchful waiting).

Assessment

In 2018, the Institute for Quality and Efficiency in Health Care (IQWiG, Germany) looked into whether ocriplasmin has any advantages or disadvantages compared with the current standard treatments for people with vitreomacular traction. The manufacturer provided five studies involving a total of 1,066 patients with mild symptoms.

Four of the five studies only lasted 6 months. In these, 592 people had treatment with ocriplasmin and 254 had injections with a placebo (fake medication). However, in order to draw any conclusions about long-term advantages or disadvantages of ocriplasmin compared with watchful waiting, longer studies are needed. Only one study monitored participants for 2 years: Here, 146 people had treatment with ocriplasmin and 74 received a placebo injection. All groups had regular check-up examinations. For people with mild symptoms, the following results were found:

More information

This information summarizes the main results of reviews produced by the Institute for Quality and Efficiency in Health Care (IQWiG, Germany). The reviews were commissioned by the German Federal Joint Committee (G-BA) as part of the “early benefit assessment of medications.” On the basis of the reviews and the hearings received, the G-BA passed a resolution on the added benefit of ocriplasmin (Jetrea).

Sources

• Institute for Quality and Efficiency in Health Care (IQWiG, Germany). Ocriplasmin – Benefit assessment according to §35a Social Code Book V . Dossier assessment; Commission A13-20. July 30, 2013. (IQWiG reports; Volume 128).
• Institute for Quality and Efficiency in Health Care (IQWiG, Germany). Ocriplasmin (vitreomacular traction, including when associated with macular hole) – Benefit assessment according to §35a Social Code Book V (reassessment after expiry of the decision). Dossier assessment; Commission A18-68. January 10, 2018. (IQWiG reports; Volume 709).

• IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

  Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. We do not offer individual consultations.

  Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.