June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
Effects of low-dose isotretinoin on rates of recurrent retinal detachment secondary to proliferative vitreoretinopathy
Author Affiliations & Notes
  • Francis DeCroos
    Retina, Wills Eye Institute, Philadelphia, PA
  • Michael Dollin
    Retina, Wills Eye Institute, Philadelphia, PA
  • Nikolas London
    Retina, Wills Eye Institute, Philadelphia, PA
    Retina Consultant San Diego, San Diego, CA
  • Lisa Maiale
    Retina, Wills Eye Institute, Philadelphia, PA
  • Philip Storey
    Retina, Wills Eye Institute, Philadelphia, PA
  • Jason Hsu
    Retina, Wills Eye Institute, Philadelphia, PA
  • James Vander
    Retina, Wills Eye Institute, Philadelphia, PA
  • Carl Regillo
    Retina, Wills Eye Institute, Philadelphia, PA
  • Footnotes
    Commercial Relationships Francis DeCroos, None; Michael Dollin, None; Nikolas London, None; Lisa Maiale, None; Philip Storey, None; Jason Hsu, None; James Vander, None; Carl Regillo, Genentech (C), Regeneron (C), Alcon (C), Thrombogenics (F), GSK (F), ACT (F)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 2852. doi:https://doi.org/
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      Francis DeCroos, Michael Dollin, Nikolas London, Lisa Maiale, Philip Storey, Jason Hsu, James Vander, Carl Regillo; Effects of low-dose isotretinoin on rates of recurrent retinal detachment secondary to proliferative vitreoretinopathy. Invest. Ophthalmol. Vis. Sci. 2013;54(15):2852. doi: https://doi.org/.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: To evaluate the effect of low-dose oral isotretinoin on recurrent retinal detachment (RD) secondary to proliferative vitreoretinopathy (PVR).

Methods: This prospective, non-randomized, open label trial studied administration of 20 mg isotretinoin daily for 12 consecutive weeks to patients following RD repair. Patients were subdivided into 2 groups: (1) recurrent RD with PVR and (2) primary RD at high risk for recurrent PVR RD. Risk factors included pre-operative grade B or worse PVR, retinal break larger than 3 disk diameters, retinal detachment greater than 2 quadrants, retinal detachment longer than 1 month without intervention, and vitreous hemorrhage. Simultaneous to enrollment in the treatment arm, an age-matched and pathology-matched cohort was identified and treated by the same group of surgeons to serve as the control arm.

Results: In the recurrent RD with PVR group, fifty-six patients received isotretinoin and 47 patients did not. With at least 3 months of follow-up, the surgical success rate with a single intervention was 70% in patients on isotretinoin versus 70% in the controls (Fisher Exact Test, two tailed p = 1.00). In the primary RD group at high risk for recurrent PVR RD group, fifty patients received isotretinoin and 57 patients did not. In this arm, the surgical success rate with a single intervention was 80% in patients on isotretinoin versus 56% in the controls (p = 0.0128). The side effects of the medication have been generally mild. However, one patient had a substantial sustained increase in transaminases.

Conclusions: In patients with recurrent RD secondary to PVR, low dose isotretinoin does not reduce rates of re-detachment. Low dose isotretinoin may reduce rates of secondary PVR detachment in patients with primary RD at high risk for developing recurrent PVR detachment.

Keywords: 655 proliferative vitreoretinopathy • 697 retinal detachment • 762 vitreoretinal surgery  
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