title: [Proliferative vitreoretinopathy: prophylactic treatment].
abstract: Proliferative vitreoretinopathy (PVR) is a complex process. It causes contractile fibrocellular membranes that may prevent retinal reattachment. PVR therefore remains one of the most severe complications of rhegmatogenous retinal detachment (RD), with an incidence of 5-11%, and is among the most frequent causes of surgical failure (50-75%). Its severity derives from the complexity of the surgery required to treat patients and from its uncertain anatomic and functional prognosis. The first step in preventing PVR is to identify patients at risk by means of clinical and/or biological factors such as the characteristics of retinal tears (large size, number) and detachment (preexisting PVR, extent), and the use of cryotherapy. Surgeons must therefore adapt their surgical approach to the risk of PVR. The study of animal models and the natural history of the condition in humans demonstrate the importance of early antiproliferative treatment in the early stage of the disease. Combining 5-fluoro-uracil and heparin in the vitrectomy infusion lowers the rate of postoperative PVR onset in patients with PVR risk factors. The evaluation of new molecules and new dosages will lead to a decisive step in the fight against PVR.
authors.affiliation: Clinique universitaire d'ophtalmologie, université J.-Fourier, CHU de Grenoble, BP 217, 38043 Grenoble cedex 09, France. Electronic address: cchiquet@chu-grenoble.fr.
authors.forename: C
authors.initials: C
authors.lastname: Chiquet
authors.affiliation: Centre d'ophtalmologie Kléber, 50, cours Franklin-Roosevelt, 69006 Lyon, France. Electronic address: fredrouberol@yahoo.fr.
authors.forename: F
authors.initials: F
authors.lastname: Rouberol
mesh_terms: D000903:Antibiotics, Antineoplastic / Q000627:therapeutic use; D003078:Colchicine / Q000627:therapeutic use; D003630:Daunorubicin / Q000627:therapeutic use; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D005472:Fluorouracil / Q000627:therapeutic use; D005938:Glucocorticoids / Q000627:therapeutic use; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D058449:Intravitreal Injections; D007641:Keratolytic Agents / Q000627:therapeutic use; D012163:Retinal Detachment / Q000517:prevention & control*; D014212:Tretinoin / Q000627:therapeutic use; D050257:Tubulin Modulators / Q000627:therapeutic use; D018630:Vitreoretinopathy, Proliferative / Q000188:drug therapy*
chemical_list: D000903:Antibiotics, Antineoplastic; D005343:Fibrinolytic Agents; D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D007641:Keratolytic Agents; D050257:Tubulin Modulators; D014212:Tretinoin; D006493:Heparin; D003078:Colchicine; D005472:Fluorouracil; D003630:Daunorubicin
keywords: 5-fluoro-uracil; Corticosteroids; Corticoïde; Daunomycin; Daunomycine; Décollement de rétine; Heparin; Héparine; Prevention; Proliferative vitreoretinopathy; Prolifération vitréo-rétinienne; Prévention; Retinal detachment