Fluorouracil for the Treatment of Massive Periretinal Proliferation

Blumenkranz, Mark S.; Ophir, Avinoam; Claflin, Alice J.; Hajek, Anthony S.

doi:10.1016/0002-9394(82)90239-2

Cited by 210 publications

(66 citation statements)

References 10 publications

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“…22,23,58 A prospective study in human eyes showed that a single injection of 10 mg of 5-FU was well tolerated. 59 However, both this study and another also using a single injection of 1 mg of 5-FU 12 did not improve the success of surgery. Recent laboratory work from our center has shown that short exposures to 5-FU result in prolonged cellular growth arrest of Tenon's capsule fibroblasts.…”

Section: Adjuvant Therapy For the Treatment Of Pvrcontrasting

confidence: 53%

Simple retinal detachments: identifying the at-risk case

Asaria

Gregor

2002

Eye

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The success rate of retinal reattachment surgery has now reached over 90%. The major cause of failure is attributable to the development of proliferative vitreoretinopathy (PVR). It is a complex process comprised of events that are similar to those of the wound healing response with inflammation, migration and proliferation of a variety of cells. These membranes can exert traction and reopen previously closed retinal breaks, create new breaks, and distort or obscure the macula.In the early part of this century the success rate of retinal reattachment surgery was virtually nil and it was not until a better understanding of the pathophysiology of retinal detachment was gained that the success rate improved. It was Gonin who emphasised the relationship between vitreous detachment and traction resulting in retinal tears that led to treatment aimed at closing retinal breaks.To increase even further the final success rate in the treatment of 'simple retinal detachments' a better understanding of the risk factors for PVR is needed in patients presenting with acute retinal detachments. Such risk factors can be broadly divided under the headings of preoperative risk factors, best surgical management and possibly adjuvant therapy.

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Section: Adjuvant Therapy For the Treatment Of Pvrcontrasting

confidence: 53%

Simple retinal detachments: identifying the at-risk case

Asaria

Gregor

2002

Eye

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“…These include pharmacological strategies to block the cellular events intrinsic to PVR. For instance, investigators have tried using antiproliferative agents to prevent PVR such as 5-fluorouracil 6 and daunomycin 7,8 that are used to treat patients with cancer. Although these approaches have shown some success in either animal models or limited clinical applications, they have not been found to be widely successful.…”

mentioning

confidence: 99%

N-Acetylcysteine Suppresses Retinal Detachment in an Experimental Model of Proliferative Vitreoretinopathy

Lei

Velez

Cui

et al. 2010

The American Journal of Pathology

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Proliferative vitreoretinopathy (PVR) is a complication that develops in 5% to 10% of patients who undergo surgery to correct a detached retina. The only treatment option for PVR is surgical intervention, which has a limited success rate that diminishes in patients with recurring PVR. Our recent studies revealed that antioxidants prevented intracellular signaling events that were essential for experimental PVR. The purpose of this study was to test whether N-acetyl-cysteine (NAC) , an antioxidant used in a variety of clinical settings , was capable of protecting rabbits from PVR. Vitreous-driven activation of PDGFR␣ and cellular responses intrinsic to PVR (contraction of collagen gels and cell proliferation) were blocked by concentrations of NAC that were well below the maximum tolerated dose. Furthermore, intravitreal injection of NAC effectively protected rabbits from developing retinal detachment, which is the sight-robbing phase of PVR. Finally, these observations with an animal model appear relevant to clinical PVR because NAC prevented human PVR vitreous-induced contraction of primary RPE cells derived from a human PVR membrane. Our observations demonstrate that antioxidants significantly inhibited experimental PVR , and suggest that antioxidants have the potential to function as a PVR prophylactic in patients undergoing retinal surgery to repair a detached retina.

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“…A single dose of 5-FU has been shown to be effective in the treatment of massive periretinal proliferation, as is shown in the experimental work of Blumenkrans et al 20 This antimetabolite has also been used to improve surgical prognosis in the eyes of human patients with glaucoma. 15 Until 1989, most researchers used a 105-mg dose in patients with high-risk glaucoma; later, reduced dosages were used, producing similar results with much fewer side effects.…”

Section: Discussionmentioning

confidence: 86%