One hundred and eighty-nine cases of retinal detachment complicated with advanced proliferative vitreoretinopathy (grade C or D)were treated with scleral buckling or vitreous surgery,The reattachment rate was 63% ,ranging from 87.5% in grade C1 to 30.4% in grade D3.Retinas were reattached in 119,of which the postoperative visual acuity was counting finger or better in 95.8% and 20/200 or better in 26.9% in those cases,of grade C1 to C2 without proliferative vitreoretinopathy. The major causes of surgical failure were development of new or recurrent anterior PVR(51.4%),posterior epiretinal proliferation making pre-existing retinal breaks open and creation of new breaks (25.7%). Finally,we discussed the time of vitreoretinal surgery,methods of operation and the formation of anterior PVR. (Chin J Ocul Fundus Dis,1994,10:199-202)
Our previous experiments showed limited results of treatment with daunomycin when given at the inflammatory stage of proliferative vitreoretinopathy(PVR)induced by macrophages in rabbits.In the present study,we observed the inhibition of intraocular cellular proliferation in the same model by daunomycin which was injected in a dosage of 5mu;g 6 days after intravitreal macrophage injection,with 3H-thymidine autoradiography.The efficacy of daunomycin was also compared with that of triamcinolone,and combined triamcinlone and daunomycin.The retinal detachment occurred in 33.3%,16.1%,8.3%and 83.3%(P<0.01) of the eyes treated with daunomycin,triamcinolone,combined drugs and the control groups,respectively.Autoradiography revealed a singnificantly decreased number of labelled nuclei of proliferative cells on days 7 and 14 in daunomycin-treated eyes(compared to controls,18.8plusmn;3.2 vs 35.7plusmn;3.4;52.1plusmn;8.0 vs 81.3plusmn;14.6,P<0.01,respectively).Significantly decreased numbers of inflammatory cells and labelled cells were also noted in eyes treated with triamcinolone and combined drugs.The results suggest that daunomycin given at the proliferative stage,and triamcionlone given at the inflammatory stage of PVR,or combined drugs can prevent traction retinal detachment. (Chin J Ocul Fundus Dis,1994,10:229-231)
An experimental model of proliferative vitretinopathy(PVR) induced by macrophages was used for the evaluation of drug efficacy of daunomycin encapsulated in liposomes in the treatment of PVR.Five mu;g daunomycin(n=40),10mu;g daunomycin-liposome(DL,n=30)and 0.1 ml saline or empty liposomes(n=40,as controls)were injected into the rabbit vitreous after macrophage injection.Retinal detachment developed in 77.5% of the control eyes on day 28,compared to 33.3% of the eyes treated with DL(P<0.01)and 50% of the daunomycin-treated eyes(P<0.05).The results suggest that encapsulation in liposomes of cytotoxic agents can enhance drug efficacy.The phasic course of development of PVR is important in the selection of particular drugs. (Chin J Ocul Fundus Dis,1993,9:77-80)
The stimulating effects of subretinal fluid (SRF) of 31 patients with rhegnmtoganous retinal detachment (among them 5 are recurrent) on the growth of fihroblasts were investigated. The results demonstrated that all samples of SRF showed stimulating effect in a variable degree.The range of proliferation-stimulating activity was from 86. 7% to 366.7% above the baseline.The stimulating ahility was mainly related to the degree of PVR and may be also related to the extent and clinical course of the detaehrnent. When stimulating rate was S0Y0 ,the dilution multiple of SRF was higher in recurrent patients than that in initiate ( P<0.01). (Chin J Ocul Fundus Dis,1993,9:11-13)