5-fluorouracil: new applications in complicated retinal detachment for an established antimetabolite.
5-fluorouracil: new applications in complicated retinal detachment for an established antimetabolite.
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DOI：
10.1016/s0161-6420(84)34318-4
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发表时间：
1984-02
期刊：
影响因子：
13.7
通讯作者：
M. Blumenkranz;E. Hernandez;A. Ophir;E. Norton
中科院分区：
文献类型：
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作者：
M. Blumenkranz;E. Hernandez;A. Ophir;E. Norton
增殖性玻璃体视网膜病变发展后视网膜的长期再附着常常被细胞再增殖的发生所阻止。5-氟尿嘧啶是一种合成的嘧啶类似物，是细胞培养和牵引性视网膜脱离动物模型中成纤维细胞增殖的有效抑制剂。通过显微镜和电生理学标准，当对家兔玻璃体内给药时，剂量高达1.0 mg时，未导致可证实的视网膜毒性。前22例晚期增生性玻璃体视网膜病变患者除巩膜扣带术和玻璃体切除术外，还接受眼周和眼内5-氟尿嘧啶联合治疗。术后6个月，60%的患者实现了视网膜复位。虽然18%的病例发生角膜上皮缺损延迟愈合，31.8%的病例发生轻微的上皮下瘢痕，但未观察到严重的全身或眼部并发症。结合标准玻璃体切除术技术、术后液体气体交换和光凝，眼周和结膜下5-氟尿嘧啶似乎可以改善增殖性玻璃体视网膜病变发展后长期视网膜复位的预后。
Long-term reattachment of the retina following the development of proliferative vitreoretinopathy is often prevented by the occurence of cellular reproliferation. 5-fluorouracil, a synthetic pyrimidine analog, is a potent inhibitor of fibroblast proliferation in cell culture and an animal model of tractional retinal detachment. Doses of up to 1.0 mg, when administered intravitreally to rabbits, result in no demonstrable retinal toxicity by microscopic and electrophysiologic criteria. The first 22 consecutive patients with advanced forms of proliferative vitreoretinopathy were treated with a combination of periocular and intraocular 5-fluorouracil, in addition to scleral buckling and vitrectomy. Retinal reattachment was achieved in 60% of patients at 6 months postoperatively. No serious systemic or ocular complications were observed although delayed healing of corneal epithelial defects occurred in 18% of cases and subtle subepithelial scarring in 31.8%. In combination with standard vitrectomy techniques, postoperative fluid gas exchange, and photocoagulation, periocular and subconjunctival 5-fluorouracil appears to improve the prognosis for longterm retinal reattachment following the development of proliferative vitreoretinopathy.