Closure of persistent macular holes with human recombinant transforming growth factor-beta 2.
OBJECTIVE
To evaluate the efficacy of human recombinant transforming growth factor-beta 2 (TGF-beta 2) in the closure of persistent macular holes.


METHODS
Retina service at a university-affiliated hospital in Vancouver.


METHODS
Seventeen patients with macular holes who had previously undergone vitrectomy, posterior cortical vitreous removal and prolonged gas tamponade, with failure to close the hole.


METHODS
Treatment with TGF-beta 2 followed by gas tamponade.


METHODS
Closure of macular hole (defined as complete absence of the surrounding neurosensory detachment).


RESULTS
Of the 17 holes 16 (94%) were closed. The average improvement in Snellen acuity was 1.76 lines; nine patients (53%) had at least two lines of improvement. The patients who gained two or more lines of acuity following surgery with TGF-beta 2 had lost significantly more lines of acuity with the primary procedure (p = 0.008) and had worse Snellen acuity following the primary procedure (p = 0.0004) than the patients who gained one line or less of acuity following surgery with TGF-beta 2. Among the patients with a final visual acuity of 20/80 or better the average duration of the hole from the onset of symptoms to the second procedure was 22.2 months.


CONCLUSIONS
Treatment with TGF-beta 2 is a potentially useful adjuvant in the closure of persistent macular holes following failed primary surgery.
Kozy
D W
DW
Vancouver Hospital/University of British Columbia Eye Care Centre.
Maberley
A L
AL
D000368:Aged; D006801:Humans; D011184:Postoperative Period; D011994:Recombinant Proteins; D012086:Reoperation; D012167:Retinal Perforations / Q000188:drug therapy* / Q000503:physiopathology / Q000601:surgery; D016212:Transforming Growth Factor beta / Q000627:therapeutic use*; D016896:Treatment Outcome; D014792:Visual Acuity
D011994:Recombinant Proteins; D016212:Transforming Growth Factor beta