Pregnancy Category: C
ClassificationTherapeutic: ocular agents
Symptomatic treatment of vitreomacular adhesion (VMA).
A proteolytic enzyme that dissolves the protein matrix present in vitreomacular adhesions.
Dissolution of vitreomacular adhesion with improved vision.
Absorption: Minimal absorption
Distribution: Action is primarily local
Metabolism and Excretion: Rapidly degraded following administration
Time/action profile (VMA resolution)
|Intravitreal||within 1 wk||3 wk||6 mos or more|
Contraindicated in: None noted.
Use Cautiously in: Lactation: Effects are not know, use caution Obstetric: Use during pregnancy only if clearly needed Pediatric: Safe and effective use in children has not been established
Adverse Reactions/Side EffectsMay be due to procedure
Ear, Eye, Nose, Throat
- blurred vision (most frequent)
- conjunctival hemorrhage (most frequent)
- ↓ visual acuity (most frequent)
- eye pain (most frequent)
- macular hole (most frequent)
- vitreous floaters (most frequent)
- retinal edema (most frequent)
- anterior chamber cell
- conjunctival hyperemia
- dry eye
- dyschromatopsia (yellow vision)
- ↑ intraocular pressure
- intraocular inflammation/infection
- intraocular hemorrhage
- lens subluxation
- macular edema
- metamorphopsia (distorted vision)
- photopsia (perceived light flashes)
- retinal degeneration
- retinal detachment
- vitreous detachment
Drug-Drug interactionNone noted.
Intravitreal (Adults) 0.125 mg injected as a single dose
Solution for intravitreal injection: 0.5 mg/0.2 mL
- Monitor for elevation in intraocular pressure following injection.
- Monitor visual acuity periodically following injection; may lead to decrease in vision.
Potential Nursing DiagnosesDeficient knowledge, related to medication regimen (Patient/Family Teaching)
- Ocriplasmin must be administered by a qualified physician.
- Intravitreal: Remove vial from freezer and allow to thaw for few min at room temperature. Add 0.2 mL of preservative free 0.9% NaCl. Swirl gently until mixed. Solution is clear and colorless without particles; do not administer solutions that are discolored or contain particulate matter. Withdraw all solution from vial with a 19 gauge needle. Replace needle with 30 gauge needle and expel excess air and solution to 0.1 mL. Discard unused solution. Administer adequate anesthesia and a broad spectrum antibiotic as per protocol. Intravitreal injection is done via aseptic technique. Repeat administration in same eye is not recommended.
- Wait 7 days before treating other eye if necessary.
- Explain procedure for intravitreal injection to patient.
- Advise patient to notify health care professional immediately if signs and symptoms of intraocular inflammation/infection (eye redness, sensitivity to light, eye pain, change in vision) occurs.
- May cause visual changes. Advise patient to avoid driving and other activities requiring good vision until response to medication is known.
- Advise female patient to notify health care professional if pregnancy is planned or suspected or if breastfeeding.
- Improved vision in patients with vitreomacular adhesions.