Intravitreal Autologous Plasmin Prepared by Urokinase for Vitreolysis: A Pilot Study

Abstract

Purpose To evaluate the effects of intravitreal autologous plasmin injection (IVAP) on vitreoretinal diseases and vitreolysis. Methods In this interventional, prospective, case series pilot study, 8 eyes were assigned to IVAP. Plasminogen as centrifuged from the patients’ plasma was converted to plasmin by adding urokinase. A total of 0.2 mL extracted plasmin was injected intravitreally. Posterior vitreous detachment (PVD) and potential injection-related complications at week 4 were the primary outcome measures. Secondary outcomes included changes in best-corrected visual acuity (VA) (logMAR) and central macular thickness (CMT). Results Mean age of the patients was 54.35 years. Two patients had complete PVD and 3 patients had partial PVD. Four patients had decrease in CMT. The VA was not changed in 6 patients, improved in 1 patient, and decreased in 1 patient. No uveitis, endophthalmitis, or postinjection vitreous hemorrhage was observed. Conclusions This pilot study demonstrated the efficacy of urokinase-prepared IVAP injection on releasing vitreomacular traction and inducing vitreolysis.