Justin S Yun, Blake H Fortes, Marcus H Yamamoto, Adrian C Au, Pradeep S Prasad, Colin A McCannel, Irena Tsui, Tara A McCannel, Hamid Hosseini, David Lozano Giral, Aya Barzelay-Wollman, Moritz S Pettenkofer, Kirk K Hou
{"title":"玻璃体内甲氨蝶呤治疗复发性孔源性视网膜脱离增生性玻璃体视网膜病变的实际疗效。","authors":"Justin S Yun, Blake H Fortes, Marcus H Yamamoto, Adrian C Au, Pradeep S Prasad, Colin A McCannel, Irena Tsui, Tara A McCannel, Hamid Hosseini, David Lozano Giral, Aya Barzelay-Wollman, Moritz S Pettenkofer, Kirk K Hou","doi":"10.1097/IAE.0000000000004602","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the efficacy of serial intravitreal methotrexate (MTX) injections as an adjunct to surgical repair in the management of recurrent rhegmatogenous retinal detachment (rRRD) due to proliferative vitreoretinopathy (PVR).</p><p><strong>Methods: </strong>A retrospective cohort study was conducted involving 41 eyes with a history of failed RRD repair presenting with rRRD and grade C1 to D PVR, treated with pars plana vitrectomy (PPV) and serial MTX injections were included, separated into group 1 (with modified GUARD protocol, n=27) and group 2 (without modified GUARD protocol, n=14). The primary outcome was retinal reattachment rate, and secondary outcomes were changes in visual acuity and postoperative complications.</p><p><strong>Results: </strong>Retinal reattachment was achieved without additional surgery in 21 (77.8%) eyes in group 1 and 10 (71.4%) in group 2 at final follow-up, with no statistical significance. Improvement in logMAR was 0.50 in group 1 and 0.44 in group 2, with a median follow-up of 12.1 months from surgery and no differences in postoperative complications.</p><p><strong>Conclusion: </strong>There were no differences in retinal reattachment or visual acuity outcomes between both methotrexate regimens. The overall reattachment rate exceeded previously reported rates for rRRD with PVR. Further research is needed to optimize the injection protocol for better clinical outcomes.</p>","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":" ","pages":""},"PeriodicalIF":2.1000,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Real-World Efficacy of Intravitreal Methotrexate for Managing Proliferative Vitreoretinopathy in Recurrent Rhegmatogenous Retinal Detachment.\",\"authors\":\"Justin S Yun, Blake H Fortes, Marcus H Yamamoto, Adrian C Au, Pradeep S Prasad, Colin A McCannel, Irena Tsui, Tara A McCannel, Hamid Hosseini, David Lozano Giral, Aya Barzelay-Wollman, Moritz S Pettenkofer, Kirk K Hou\",\"doi\":\"10.1097/IAE.0000000000004602\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>To evaluate the efficacy of serial intravitreal methotrexate (MTX) injections as an adjunct to surgical repair in the management of recurrent rhegmatogenous retinal detachment (rRRD) due to proliferative vitreoretinopathy (PVR).</p><p><strong>Methods: </strong>A retrospective cohort study was conducted involving 41 eyes with a history of failed RRD repair presenting with rRRD and grade C1 to D PVR, treated with pars plana vitrectomy (PPV) and serial MTX injections were included, separated into group 1 (with modified GUARD protocol, n=27) and group 2 (without modified GUARD protocol, n=14). The primary outcome was retinal reattachment rate, and secondary outcomes were changes in visual acuity and postoperative complications.</p><p><strong>Results: </strong>Retinal reattachment was achieved without additional surgery in 21 (77.8%) eyes in group 1 and 10 (71.4%) in group 2 at final follow-up, with no statistical significance. Improvement in logMAR was 0.50 in group 1 and 0.44 in group 2, with a median follow-up of 12.1 months from surgery and no differences in postoperative complications.</p><p><strong>Conclusion: </strong>There were no differences in retinal reattachment or visual acuity outcomes between both methotrexate regimens. The overall reattachment rate exceeded previously reported rates for rRRD with PVR. Further research is needed to optimize the injection protocol for better clinical outcomes.</p>\",\"PeriodicalId\":54486,\"journal\":{\"name\":\"Retina-The Journal of Retinal and Vitreous Diseases\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2025-07-03\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Retina-The Journal of Retinal and Vitreous Diseases\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/IAE.0000000000004602\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"OPHTHALMOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Retina-The Journal of Retinal and Vitreous Diseases","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/IAE.0000000000004602","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
Real-World Efficacy of Intravitreal Methotrexate for Managing Proliferative Vitreoretinopathy in Recurrent Rhegmatogenous Retinal Detachment.
Purpose: To evaluate the efficacy of serial intravitreal methotrexate (MTX) injections as an adjunct to surgical repair in the management of recurrent rhegmatogenous retinal detachment (rRRD) due to proliferative vitreoretinopathy (PVR).
Methods: A retrospective cohort study was conducted involving 41 eyes with a history of failed RRD repair presenting with rRRD and grade C1 to D PVR, treated with pars plana vitrectomy (PPV) and serial MTX injections were included, separated into group 1 (with modified GUARD protocol, n=27) and group 2 (without modified GUARD protocol, n=14). The primary outcome was retinal reattachment rate, and secondary outcomes were changes in visual acuity and postoperative complications.
Results: Retinal reattachment was achieved without additional surgery in 21 (77.8%) eyes in group 1 and 10 (71.4%) in group 2 at final follow-up, with no statistical significance. Improvement in logMAR was 0.50 in group 1 and 0.44 in group 2, with a median follow-up of 12.1 months from surgery and no differences in postoperative complications.
Conclusion: There were no differences in retinal reattachment or visual acuity outcomes between both methotrexate regimens. The overall reattachment rate exceeded previously reported rates for rRRD with PVR. Further research is needed to optimize the injection protocol for better clinical outcomes.
期刊介绍：
RETINA® focuses exclusively on the growing specialty of vitreoretinal disorders. The Journal provides current information on diagnostic and therapeutic techniques. Its highly specialized and informative, peer-reviewed articles are easily applicable to clinical practice.
In addition to regular reports from clinical and basic science investigators, RETINA® publishes special features including periodic review articles on pertinent topics, special articles dealing with surgical and other therapeutic techniques, and abstract cards. Issues are abundantly illustrated in vivid full color.
Published 12 times per year, RETINA® is truly a “must have” publication for anyone connected to this field.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
