Dual Application of Methotrexate Improves Functional and Anatomical Outcomes in Diabetic Tractional Retinal Detachment.

IF 0.9 4区医学 Q4 OPHTHALMOLOGY

Ophthalmic surgery, lasers & imaging retina Pub Date : 2025-05-01 Epub Date: 2025-02-01 DOI:10.3928/23258160-20250127-03

Abdallah Safwat, Mohamed Abdullah, Ahmed Shawkat Abdelhalim, Rabei Hassanien, Khaled Mourad, Mohamed Tarek Moustafa

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引用次数: 0

Abstract

Background and objective: This study evaluated the use of a dual-delivery methotrexate (MTX) strategy for diabetic tractional retinal detachment (TRD). Diabetic retinopathy (DR) is a leading cause of blindness. Inflammation plays a key role in TRD, and MTX has anti-inflammatory properties.

Patients and methods: This is a pilot study that included 60 patients with TRD. They were block randomized to either MTX with pars plana vitrectomy (PPV) (n = 30) or PPV alone (control, n = 30). MTX was added to the irrigation fluid during surgery and an intra-silicone injection at the end. One month after silicone oil removal, visual acuity (VA), multifocal electroretinography (mfERG), and spectral-domain optical coherence tomography (SD-OCT) were assessed.

Results: One month after silicone oil removal, VA and mfERG were significantly better with a lower prevalence of epiretinal membranes, disorganization of retinal inner layers, and cystic macular changes by SD-OCT in the MTX group.

Conclusion: This study found that dual-delivery MTX during PPV is a promising strategy to improve functional and anatomical results in diabetic TRD. [Ophthalmic Surg Lasers Imaging Retina 2025;56:298-305.].

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双重应用甲氨蝶呤改善糖尿病牵引性视网膜脱离的功能和解剖结果。

背景和目的：本研究评估了双重给药甲氨蝶呤（MTX）治疗糖尿病牵引性视网膜脱离（TRD）的策略。糖尿病视网膜病变（DR）是导致失明的主要原因。炎症在TRD中起关键作用，而MTX具有抗炎特性。患者和方法：这是一项包括60例TRD患者的初步研究。他们被随机分组到MTX联合玻璃体切除（PPV）组（n = 30）或单纯PPV组（对照组，n = 30）。术中在冲洗液中加入MTX，最后进行硅胶内注射。硅油去除1个月后，评估视力（VA）、多焦视网膜电图（mfERG）和光谱域光学相干断层扫描（SD-OCT）。结果：在硅油去除1个月后，MTX组的VA和mfERG明显改善，SD-OCT显示视网膜前膜、视网膜内层紊乱和囊性黄斑改变的发生率较低。结论：本研究发现PPV期间双给药MTX是改善糖尿病TRD功能和解剖结果的有希望的策略。[眼科外科激光成像视网膜2025；56:XX-XX]。

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来源期刊

Ophthalmic surgery, lasers & imaging retina OPHTHALMOLOGY-SURGERY

CiteScore

1.80

自引率

0.00%

发文量

期刊介绍： OSLI Retina focuses exclusively on retinal diseases, surgery and pharmacotherapy. OSLI Retina will offer an expedited submission to publication effort of peer-reviewed clinical science and case report articles. The front of the journal offers practical clinical and practice management features and columns specific to retina specialists. In sum, readers will find important peer-reviewed retina articles and the latest findings in techniques and science, as well as informative business and practice management features in one journal.