Vitreosolve: A Comprehensive Analysis of its Development and Discontinuation in Pharmacologic Vitreolysis

I. Introduction to Vitreosolve

A. Overview and Identification

Vitreosolve was an investigational pharmaceutical agent developed within the field of pharmacologic vitreolysis. This field seeks to utilize non-surgical methods, primarily intravitreal drug delivery, to modify the structure of the vitreous humor and its interface with the retina, thereby treating or preventing various ocular pathologies associated with vitreoretinal adhesion or traction.[1] The vitreous humor, a gel primarily composed of water, collagen fibrils, and hyaluronan, plays a crucial role in maintaining eye structure but can contribute to diseases like diabetic retinopathy, macular holes, and vitreomacular traction when age-related or pathological changes occur, particularly incomplete posterior vitreous detachment (PVD).[1]

Vitreosolve was distinctively classified as a non-enzymatic agent, setting it apart from other vitreolytic approaches explored concurrently, such as those employing enzymes like plasmin, microplasmin (ocriplasmin), hyaluronidase, or dispase to cleave specific molecular components of the vitreous or vitreoretinal interface.[1] It was identified as a proprietary small molecule formulation belonging to the carbomide family, specifically characterized as being urea-based.[1] The intended route of administration was via intravitreal injection directly into the vitreous cavity.[10]