Chang Yo-Chen, Hu Dan-Ning, Wu Wen-Chuan
Department of Ophthalmology, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, No. 100 Zihyou 1st Road, Kaohsiung, Taiwan.
Am J Ophthalmol. 2008 Sep;146(3):440-446. doi: 10.1016/j.ajo.2008.05.002. Epub 2008 Jul 2.
To determine whether postoperative oral 13-cis-retinoic acid (RA) treatment could improve the outcome of vitreoretinal surgery with silicone oil for the management of proliferative vitreoretinopathy (PVR).
Prospective controlled randomized interventional case series.
This study included 35 eyes of 35 patients with primary rhegmatogenous retinal detachment and PVR. All patients underwent surgical repair by similar procedures. The RA group consisted of 16 patients who received 10 mg oral RA twice daily for eight weeks postoperatively. The control group included 19 patients without taking RA. The outcome measure included the rate of retinal attachment, macular pucker formation, ambulatory vision, and RA-related side effects.
At last follow-up (at least one year postoperatively), 15 of 16 eyes (93.8%) in the RA group and 12 of 19 eyes (63.2%) in the control group maintained retinal attachment (P = .047). The rate of macular pucker formation was significantly lower in the RA group (18.8% vs 78.9% in the control group; P = .001). A higher rate of ambulatory vision was achieved in the RA group as compared to the control group (56.3% vs 10.5%; P = .009).
Postoperative administration with oral moderate dosage of RA for eight weeks appears to maintain retinal attachment, decrease the macular pucker, and improve vision after surgical repair for eyes with PVR.
确定术后口服13-顺式维甲酸(RA)治疗能否改善采用硅油治疗增生性玻璃体视网膜病变(PVR)的玻璃体视网膜手术的疗效。
前瞻性对照随机干预病例系列研究。
本研究纳入35例原发性孔源性视网膜脱离合并PVR患者的35只眼。所有患者均采用相似手术方式进行手术修复。RA组由16例患者组成,术后8周每天口服10mg RA,每日2次。对照组包括19例未服用RA的患者。观察指标包括视网膜复位率、黄斑皱襞形成情况、活动视力以及与RA相关的副作用。
在最后一次随访时(术后至少1年),RA组16只眼中有15只(93.8%)视网膜保持复位,对照组19只眼中有12只(63.2%)视网膜保持复位(P = 0.047)。RA组黄斑皱襞形成率显著低于对照组(18.8% 对78.9%;P = 0.001)。与对照组相比,RA组获得活动视力的比例更高(56.3% 对10.5%;P = 0.009)。
术后口服中等剂量RA 8周似乎可维持视网膜复位,减少黄斑皱襞形成,并改善PVR患者手术修复后的视力。