Table 2.
Outcomes of randomized, controlled, clinical trials in humans with and without proliferative vitreoretinopathy (PVR).
| Agent(s) | Dose and target | Patients | Treatment groups | Outcomes | Ref. |
|---|---|---|---|---|---|
| 5-FU and LMWH | 200 μg/mL 5-FU and 5 IU/mL LMWH, 5-FU inhibits DNA synthesis and fibroblast proliferation; LMWH binds fibronectin, bFGF, PDGF, and other growth factors |
174 patients at High risk for PVR |
Intravitreal inf.: placebo versus 5-FU and LMWH | Placebo: 23/87 (26.4%) postoperative PVR, 22/87 (25.3%) reoperation with 16/22 (72.7%) due to PVR 5-FU and LMWH: 11/87 (12.6%, P = 0.02*) postoperative PVR, 17/87 (19.5%) reoperation with 9/17 (52.9%) due to PVR No difference in visual acuity outcomes, nor complication rates |
[68] |
|
| |||||
| 5-FU and LMWH | 200 μg/mL 5-FU and 5 IU/mL LMWH, For target, see Row 1 above |
157 patients with established grade C PVR | Intravitreal inf.: placebo versus 5-FU and LMWH | Placebo: 51% (n = 84) retinal reattachment (RRA) at 6 months with no reoperation 5-FU and LMWH: 56% (n = 73) RRA at 6 months with no reoperation (χ2 = 2.9, P = 0.59) |
[69] |
|
| |||||
| 5-FU and LMWH | 200 μg/mL 5-FU and 5 IU/mL LMWH, For target, see Row 1 above |
615 patients with unselected primary RRD | Intravitreal inf.: placebo versus 5-FU and LMWH | Placebo: 86.8% RRA, 4.9% development of PVR, (n = 288) 5-FU and LMWH: 82.3% RRA (P = 0.12), 7% development of PVR (P = 0.072), (n = 327) No difference in final mean visual acuity |
[70] |
|
| |||||
| Dauno-rubicin | 7.5 μg/mL, inhibits cell proliferation and migration |
286 patients with advanced preoperative PVR after RRD |
Surgery only versus surgery with intravitreal inf. of daunorubicin | Surgery only: 73/135 (54.1%) RRA with no reoperation at 6 months Surgery and daunorubicin: 89/142 (62.7%) RRA with no reoperation a 6-month post-op (P = 0.07) Daunorubicin: less reoperation 1st year postop (46.1% versus 34.5%, P = 0.005*) |
[75] |
|
| |||||
| 13-cis-retinoic acid (13cRA) | 10 mg orally, 2x daily, for 8 weeks, inhibits proliferation of RPE cells |
35 patients with primary retinal detachment and PVR | Surgery only versus surgery and oral 13cRA | Surgery only: 12/19 (63.2%) RRA at one-year follow-up Surgery and 13cRA: 15/16 (93.8%) RRA at one-year followup (P = 0.047*) |
[80] |
5-FU: 5-fluorouracil. LMWH: low-molecular-weight heparin. bFGF: basic fibroblast growth factor. PDGF: platelet-derived growth factor. inf.: infusion. RRD: rhegmatogenous retinal detachment. post-op: postoperative. *statistically significant difference compared to control. RRA: retinal reattachment. RPE: retinal pigment epithelium. 13cRA: 13-cis-retinoic acid. Ref: Reference number.