A New Pharmacological Vitreolysis through Mixed Fruit Enzymes for Ocular Floaters and Vitreous Hemorrhage-Induced Floaters

Overview

• Research Study: Investigates the effects of mixed fruit enzymes (MFEs) on ocular floaters and vitreous hemorrhage-induced floaters.
• Enzymes Used: Bromelain (190 mg), Papain (95 mg), Ficin (95 mg).
• Study Design: Double-blind clinical trial with 224 patients.
• Objective: Evaluate the effectiveness of MFEs in reducing spontaneous symptomatic vitreous opacities (SVOs) and those secondary to vitreous hemorrhage (VH).

Introduction

• Vitreous Composition: Comprising collagen fibers and a hydrated extracellular matrix (ECM).
• Floaters: Result from vitreous degeneration or blood clots, affecting visual function.
• Vitreous Degeneration: Involves HA depolymerization, water loss, and collagen fibril disorganization, leading to floaters.

Study Methods

• Participants: 224 patients aged 30-60 years with monocular SVOs.
• Trial Groups: Divided into placebo (Vitamin C) and 3 levels of MFE dosage (low, middle, high).
• Duration: 3 months, with monitoring of SVOs and visual acuity.
• Antioxidant Assay: DDPH test used to compare free radical scavenging ability.

Results

• Disappearance Rates:
  • Spontaneous SVOs: 55% (1 capsule), 62.5% (2 capsules), 70% (3 capsules).
  • VH-induced SVOs: 18% (1 capsule), 25% (2 capsules), 56% (3 capsules).
• Visual Acuity Improvement: Patients' vision improved from 0.63LogMAR to 0.19LogMAR.
• Patient Satisfaction: High satisfaction and improved quality of life reported.

Discussion

• Mechanism: MFEs promote vitreolysis through hydrolytic and collagenolytic activities.
• Antioxidant Capabilities: MFEs showed significant free radical scavenging over Vitamin C.
• Clinical Implications: MFEs are a safer alternative to invasive treatments like YAG laser or PPVT.

Conclusion

• Efficacy: High-dose oral supplementation of MFEs effectively reduces vitreous opacities and improves visual outcomes.
• Patient Outcomes: High satisfaction and enhanced visual acuity post-treatment.

Keywords

• Ocular floater, vitreous hemorrhage, bromelain, papain, ficin, pharmacologic vitreolysis.

References

• Key References: Studies on pharmacologic vitreolysis, antioxidant assays, and clinical outcomes of ocular floater treatments.

Additional Information

• IRB and Ethics: Study adhered to ethical guidelines and received relevant approvals.
• Funding: No external funding received.
• Conflicts of Interest: None declared by authors.