Abstract
In a prospective clinical trial, the effect of systemic steroids on the incidence and severity of retinal fibrosis following retinal detachment surgery was tested against placebo. Several grades of retinal fibrosis of various degrees of severity were defined prior to the study. The maximum postoperative incidence of eyes with any signs of retinal fibrosis was 65% (75.4% in the placebo group, 63.3% in the steroid group). A set of fibrosis criteria was identified that had a tendency to respond to systemic steroids with a statistical significance increasing with time. The majority of these steroid-responsive criteria was of a mild degree and located at the posterior pole. The mean visual acuity was significantly lower in eyes with retinal fibrosis. The effect of systemic steroids on retinal fibrosis tested under clinical conditions was considerably weaker than that known from experimental conditions with intravitreal injections of triamcinolone acetonide.
Zusammenfassung
In einer Doppelblindstudie wurde der Effekt systemischer Corticosteroide auf die Entwicklung einer retinalen Fibroplasie nach Netzhautoperationen an 141 Patienten geprüft. Vor der Studie wurde eine Reihe von Fibroplasie-Kriterien unterschiedlichen Schweregrads definiert. 4–6 Monate postoperativ erreichte die Häufigkeit von Augen mit Fibroplasie-Zeichen einen Gipfel von 65% (75,4% in der Placebo-Gruppe, 63,3% in der Steroid-Gruppe). Der durchschnittliche Visus von Augen mit Fibroplasie war im gesamten Zeitraum von 6 Monaten signifikant geringer als an operierten Kontrollaugen. Eine ausgewählte Gruppe meistens leichtgradiger, am hinteren Funduspol lokalisierter Fibroplasie-Zeichen reagierte signifikant positiv auf systemische Steroid-Gaben. Der Effekt war jedoch wesentlich geringer als im Tierexperiment nach intravitrealen Gaben von Triamcinolone.
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Koerner, F., Merz, A., Gloor, B. et al. Postoperative retinal fibrosis — a controlled clinical study of systemic steroid therapy. Graefe's Arch Clin Exp Ophthalmol 219, 268–271 (1982). https://doi.org/10.1007/BF00231411
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DOI: https://doi.org/10.1007/BF00231411