Intravitreal functional plasminogen in branch retinal vein occlusion

Reviewed by Bheemanagouda Patil

Branch retinal vein occlusion (BRVO) is the second most common vascular disorder of the eye. Intravitreal injections of anti-VEGF agents and corticosteroids have proven efficacy. Posterior vitreous cortex (PVC) adhesion has been shown to support the development of retinal vein occlusion. The induction of a complete posterior vitreous detachment (PVD) is of benefit to BRVO-affected eyes. If intravitreal plasminogen is present in eyes with BRVO, then intravitreally applied tissue Plasminogen activator (t-PA) will activate plasminogen into the active enzyme plasmin, thus facilitating PVD development. In this study, vitreous taps were taken from central vitreous body and plasminogen was functionally determined in a p-nitroanilide reaction after activation with streptokinase (100% of normal, %N = functional plasminogen in pooled normal citrated plasma). Intravitreal functional plasminogen was detected in all analysed samples (n=30) and mean plasminogen activities were found to be 0.97±1.06%N (range: 0.03-3.9%N). The study concluded that intravitreal functional plasminogen is significantly elevated in eyes with BRVO and intravitreal t-PA should be further explored to induce PVD.

Intravitreal functional plasminogen in eyes with branch retinal vein occlusion.
Bertelmann T, Sekundo W, Strodthoff S, et al.
OPHTHALMIC RESEARCH
2014;52(2):74-80.