Transforming growth factor-beta 2 significantly enhances the ability to flatten the rim of subretinal fluid surrounding macular holes. Preliminary anatomic results of a multicenter prospective randomized study.
Previous studies of treatment of full-thickness macular holes have effected resolution of the surrounding subretinal fluid cuff in 58%-71% of cases. An initial report has found 330 ng and 1,330 ng transforming growth factor-beta 2 to be successful in effecting resolution of the surrounding subretinal fluid cuff in 100% of cases. A randomized, masked, controlled, prospective, multicenter study of 90 patients with full-thickness macular holes was performed to assess the efficacy of the local application of TGF-beta 2 at the time of vitrectomy surgery. Eligibility criteria included: (1) best corrected visual acuity of 20/80 or worse; (2) duration of macular hole for less than 1 year; and (3) absence of other ocular disorders that might interfere with vision. Patients were evenly randomized to receive placebo, 660 ng transforming growth factor-beta 2, or 1,330 ng transforming growth factor-beta 2. The treatment assignment was unmasked at the examination 3 months after treatment only if the macular hole failed to close. If the initial treatment had been placebo, patients were offered crossover to 1,330 ng transforming growth factor-beta 2 during a reoperation. It can be deduced that resolution of the subretinal fluid cuff occurred in 16 of 30 placebo-treated eyes, 53 of 58 eyes treated with transforming growth factor-beta 2, and in 9 of 13 cases (69%) initially treated with placebo that subsequently underwent repeat surgery under the crossover option.(ABSTRACT TRUNCATED AT 250 WORDS)
Smiddy
W E
WE
Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami School of Medicine, Florida.
Glaser
B M
BM
Thompson
J T
JT
Sjaarda
R N
RN
Flynn
H W
HW
Hanham
A
A
Murphy
R P
RP
D000368:Aged; D000369:Aged, 80 and over; D005122:Exudates and Transudates; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D012160:Retina / Q000503:physiopathology*; D012167:Retinal Perforations / Q000503:physiopathology* / Q000601:surgery / Q000628:therapy*; D016212:Transforming Growth Factor beta / Q000008:administration & dosage* / Q000627:therapeutic use; D014792:Visual Acuity; D014821:Vitrectomy; D014945:Wound Healing
D016212:Transforming Growth Factor beta