April 2010
Volume 51, Issue 13
ARVO Annual Meeting Abstract  |   April 2010
The Diabetic Vitreoretinal Juncture: Composition, Classification and MIVI II-DME Trial Results
Author Affiliations & Notes
  • M. T. Trese
    Associated Retinal Consultants, Royal Oak, Michigan
  • L. Ho
    Associated Retinal Consultants, Royal Oak, Michigan
  • T. Asami
    Associated Retinal Consultants, Royal Oak, Michigan
  • Footnotes
    Commercial Relationships  M.T. Trese, Thrombogenics, I; Thrombogenics, C; L. Ho, None; T. Asami, None.
  • Footnotes
    Support  None.
Investigative Ophthalmology & Visual Science April 2010, Vol.51, 4656. doi:
  • Views
  • Share
  • Tools
    • Alerts
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      M. T. Trese, L. Ho, T. Asami; The Diabetic Vitreoretinal Juncture: Composition, Classification and MIVI II-DME Trial Results. Invest. Ophthalmol. Vis. Sci. 2010;51(13):4656.

      Download citation file:

      © ARVO (1962-2015); The Authors (2016-present)

  • Supplements

Purpose: : to describe the composition of the diabetic vitreoretinal juncture (VRJ), Propose a classification system for the diabetic VRJ, and apply to the MIVI II-DME trial results

Methods: : An analysis of the composition of the VRJ and how it changes over time as well as a proposed classification system of the VRJ in diabetic eyes based on duration of known diabetes, HbA1C, previous laser treatment and area of VR attachment. This system is then used to analyze human eyes of diabetic patients in the MIVI II-DME trial of Microplasmin. This included 51 eyes of 51 patients in a dose escalating (25, 75,125 micrograms) sham controlled trial.

Results: : show that the composition of the diabetic VRJ vary based on an increased production of fibronectin, laminin and type 4 collagen with exposure to hyperglycemia over time. This change in composition is the most likely the reason for diabetic eyes developing vitreoschisis of the posterior hyaloid. A classification system based on duration of diabetes, HBA1C values, area of attachment and previous laser treatment may predict who will respond to enzymatic cleavage of the VRJ. The MIVI II-DME study without any systematic analysis of the population showed that some eyes (11-17%) could cleave the diabetic VRJ with Microplasmin alone by OCT and Ultrasound criteria. Careful case selection can cause the cleavage rate to increase.

Conclusions: : A better understanding of the anatomic composition and classification of vitreoretinal juncture of diabetic eyes can aid in choosing therapy to cleave the vitreoretinal juncture by enzyme or surgery or a combination of both

Clinical Trial: : www.clinicaltrials.gov NCT00412451

Keywords: diabetes • diabetic retinopathy • drug toxicity/drug effects 

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.