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5-fluorouracil: new applications in complicated retinal detachment for an established antimetabolite.

Abstract
Long-term reattachment of the retina following the development of proliferative vitreoretinopathy is often prevented by the occurrence 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, post-operative 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.
AuthorsM Blumenkranz, E Hernandez, A Ophir, E W Norton
JournalOphthalmology (Ophthalmology) Vol. 91 Issue 2 Pg. 122-30 (Feb 1984) ISSN: 0161-6420 [Print] United States
PMID6709326 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, Non-P.H.S., Research Support, U.S. Gov't, P.H.S.)
Chemical References
  • Fluorouracil
Topics
  • Adolescent
  • Adult
  • Aged
  • Animals
  • Cell Division (drug effects)
  • Cells, Cultured
  • Female
  • Fluorouracil (adverse effects, therapeutic use)
  • Humans
  • Male
  • Middle Aged
  • Rabbits
  • Retinal Detachment (classification, drug therapy, surgery)
  • Retinal Diseases (complications, drug therapy)
  • Vitreous Body

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