Postoperative Methotrexate to Reduce Reoperation Rate and Improve Vision in Patients With Complex Retinal Detachments, Advanced Diabetic Retinopathy, and Trauma.

IF 0.5 Q4 OPHTHALMOLOGY
Lauren Gibson, Alyson Nguyen, Jared Ridgeway, Mariam Omar, Christopher Purvis, Yazen Shihab, Christopher D Riemann, Alan J Franklin
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Abstract

Purpose: To identify the potential benefits of postoperative intravitreal (IVT) methotrexate (MTX) for proliferative vitreoretinopathy (PVR), trauma, or advanced diabetic retinopathy (DR). Methods: A retrospective chart review was performed of previously unoperated eyes at high risk for failure as a result of preexisting PVR, trauma, or advanced DR. Patients were included who had retinal detachment (RD) surgery for the following reasons: failed previous retinal reattachment surgery, advanced proliferative DR (PDR), initial surgery for RD associated with trauma, or primary RD associated with grade C PVR. MTX 200 to 400 µg was administered intravitreally at postoperative weeks 1, 2, 4, 7, and 11. Data analyzed included the reoperation rate, visual acuity (VA), physical examination findings, and optical coherence tomography biomarkers. Results: Of the 255 eyes evaluated, 94 received IVT MTX (MTX group) and 161 eyes did not (control group). The mean number of reoperations was 0.39 in the MTX group and 0.94 in the control group (P < .01). The MTX group had a mean gain in VA of 1 line, while the control group had a mean loss of 2.9 lines (P < .01). Conclusions: Postoperative IVT MTX in eyes with advanced PDR or complicated RD yields comparable effective results, including reduced reoperation rates and improved VA.

术后甲氨蝶呤对复杂性视网膜脱离、晚期糖尿病视网膜病变和创伤患者降低再手术率和改善视力的作用。
目的:确定术后玻璃体内(IVT)甲氨蝶呤(MTX)治疗增殖性玻璃体视网膜病变(PVR)、创伤或晚期糖尿病视网膜病变(DR)的潜在益处。方法:回顾性回顾由于既往存在的PVR、创伤或晚期PVR而未手术失败的高风险眼睛的病例表,包括因以下原因进行视网膜脱离(RD)手术的患者:既往视网膜再附着手术失败、晚期增殖性DR (PDR)、首次手术合并创伤的RD或原发性RD合并C级PVR。术后第1、2、4、7和11周给予MTX 200至400µg玻璃体内注射。分析的数据包括再手术率、视力(VA)、体格检查结果和光学相干断层扫描生物标志物。结果:255只眼中,94只眼接受了MTX治疗(MTX组),161只眼未接受MTX治疗(对照组)。MTX组平均再手术次数为0.39次,对照组平均再手术次数为0.94次(P < 0.01)。MTX组VA平均增加1行,对照组平均减少2.9行(P < 0.01)。结论:晚期PDR或复杂RD的眼术后IVT MTX疗效相当,包括降低再手术率和改善VA。
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来源期刊
CiteScore
1.20
自引率
16.70%
发文量
0
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