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Nikolas J. London, Richard S. Kaiser, Rayan A. Alshareef, Mohammed Khuthaila, Vanessa A. London, Omesh P. Gupta, Jason Hsu, James F. Vander, Marc J. Spirn, Carl D. Regillo; Determining the Effect of Low-dose Isotretinoin on Proliferative Vitreoretinopathy. Invest. Ophthalmol. Vis. Sci. 2012;53(14):5789.
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To evaluate the effect of low dose oral isotretinoin on recurrent retinal detachment in cases complicated by or at risk for proliferative vitreoretinopathy.
Prospective, non-randomized, cohort, with simultaneous, retrospective age-matched, pathology-matched control group. Following retinal detachment repair, patients receive isotretinoin 20mg PO daily for 12 consecutive weeks. There are two study arms: 1) patients with recurrent retinal detachment with proliferative vitreoretinopathy, and 2) patients with primary retinal detachment at high risk for proliferative vitreoretinopathy formation.
This study is ongoing and preliminary results are reported here. Updated results will be reported at the meeting. In our group with recurrent detachment group associated with proliferative vitreoretinopathy we have recruited 18 and 19 patients in the isotretinoin and control groups, respectively. With a minimum of 3 months of follow-up, the surgical success rate in the isotretinoin group with a single intervention is 85%, compared to 58% in the control group. For patients with primary retinal detachment at high risk for proliferative vitreoretinopathy formation, we have recruited 18 and 73 patients in the isotretinoin and control groups, respectively. In this arm, the surgical success rate in the isotretinoin group with a single intervention was 94%, compared to 68% in the control group. The side effects of the medication have been generally mild, with most patients experiencing only dry lips and/or mouth.
Isotretinoin shows promise for treating and preventing proliferative vitreoretinopathy. Completion of this study and further randomized studies are needed.
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