Abstract
In a prospective study of the effect of postoperative radiation therapy for the prevention of reproliferation of membranes and recurrent proliferative vitreoretinopathy (PVR) two similar groups of patients with retinal detachment and PVR grade D1 to D3 in one eye were compared. Half the eyes (30) received a total dose of 3000 cGy after surgery; the other half remained untreated. After a followup of 6 months and 14 months or more (maximum 36 months) the anatomical and functional results of each group were compared. After 6 months in the unirradiated group 57% (17/30) remained attached and 43% (13/30) had detached again. In the irradiated group 63% (19/30) were attached and 37% (11/30) had detached. However, there was no statistically significant difference between the two groups (P=0.479, Fisher's Exact Test). After 14 months the number of cured and uncured eyes remained the same in the unirradiated group, while in four of the eyes in the irradiated group a later onset of reproliferation and detachment occurred (after 7, 8, 12 and 14 months, respectively). A final cure rate of 57% (17/30) was achieved in the unirradiated group and a 50% (15/30) cure rate in the irradiated group. Thus the failure rate was 43% (13/30) in the unirradiated group and 50% (15/30) in the irradiated group (P=0.473, Fisher's Exact Test). No side effects from the radiation were observed in any case and no radiation retinopathy occurred during an observation period of up to 3 years. The visual acuity of the cured treated and cured untreated eyes was similar in the two groups. From these results we conclude that immediate radiation treatment does not improve the long-term results and does not reduce the number of reoperations. In a considerable number of treated eyes the onset of reproliferation was delayed from 7 to 14 months, whereas in the untreated group reproliferation was always observed during the first 6 months. A combination of various antiproliferative and antiinflammatory therapies are needed to suppress recurrent PVR after succesful vitreoretinal surgery and to minimize the side effects of these treatments.
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References
Algvere P, Koch E (1976) Experimental fibroplasia in the rabbit vitreous. Retinal detachment induced by autologous fibroblasts. Graefe's Arch Clin Exp Ophthalmol 199:215–222
Binder S (1982) Klinische und experimentelle Ergebnisse in der Behandlung der massiven periretinalen Proliferation (MPP), der prognostisch ungiinstigsten Form der Netzhautablösung. Wien Klin Wochenschr 94:[Suppl 139]:1–32
Binder S, Riss B, Skorpik C, Kulnig W (1983) Inhibition of experimental intraocular proliferation with intravitreal 5-fluouracil. Graefe's Arch Clin Exp Ophthalmol 221:126–132
Binder S, Skorpik C, Paroussis P, Menapace R (1986) Inhibition of experimental proliferation and retinal detachment by various drugs. In: Blankenship GW, Stirpe M, Gonvers M, Binder S (eds) Basic and advanced vitreous surgery. Liviane Press, Padual, pp 404–414
Binder S, Velikay M, Stolba U, Kulnig W (1989) High energy electrons used to inhibit intraocular proliferations. In: Heimann K, Wiedeman P (eds) Proliferative vitreoretinopathy. Kaden, Heidelberg, pp 265–267
Blumenkranz M, Ophir A, Claflin AJ, Hajek A (1983) Fluouracil for the treatment of massive periretinal proliferation. Am J Ophthalmol 94:458–467
Brennan MW Leone CR, Janaki L (1983) Radiation therapy for Graves disease. Am J Ophthalmol 96:195–198
Chakravarthy U, McCormick D, Maguire CJ, Archer DB (1987) An invitro study of irradiated vitreo-retinal membranes. Eye 1:126–135
Heimann K, Wiedemann P (1989) Proliferative vitreoretinopathy. Kaden, Heidelberg
Körner F, Merz A, Gloor B, Wagner E (1987) Postoperative retinal fibrosis — a controlled clinical study of systemic steroid therapy. Graefe's Arch Clin Exp Ophthalmol 225:303–307
Kulnig W, Binder S, Riss B, Skorpik C (1984) Inhibition of experimental intraocular proliferation with intravitreal 5-fluouracil. E-microscopic study. Ophthalmologica 188:248–258
Machemer R, Laqua H (1975) Pigment epithelium proliferation in retinal detachment (massive periretinal proliferation). Am J Ophthalmol 80:1–23
Meredith TA, Ficker L, Stevens R, Olkovsky Z et al. (1988) Suppression of experimental tractional retinal detachment by low-dose-radiation therapy. Arch Ophthalmol 106:676–679
The Retina Society Terminology Committee (1983) The classification of retinal detachment with proliferative vitreoretinopathy. Ophthalmology 90:121–125
Tano Y, Chandler E, Machemer R (1980) Treatment of intraocular proliferation with intravitreal injection of triamcinolone acetonide. Am J Ophthalmol 90:810–816
Wiedemann P (1988) Die medikamentöse Behandlung der proliferativen Vitreoretinopathie Enke Copythek. Ferdinand Enke, Stuttgart, pp 71–105
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Binder, S., Bonnet, M., Velikay, M. et al. Radiation therapy in proliferative vitreoretinopathy. Graefe's Arch Clin Exp Ophthalmol 232, 211–214 (1994). https://doi.org/10.1007/BF00184007
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DOI: https://doi.org/10.1007/BF00184007