Role of Systemic Anti-Tumor Necrosis Factor Alpha Treatment in the Reduction of Proliferative Vitreoretinopathy

  1. Laura Jimeno 2
  2. Maria Rosa Sanabria 7
  3. Ivan Fernández Bueno 2
  4. Lior Lipski 3
  5. Anat Loewenestein 3
  6. Amandio Rocha-Sousa 1
  7. Cristina Ferreira-Sousa 1
  8. Alfredo Adan 5
  9. Marina Mesquida 5
  10. Salvatore Di Lauro 4
  11. Jose María Ruiz-Moreno 6
  12. Ignacio Flores 6
  13. Marta Fernandez 4
  14. Alfredo Garcia Layana 8
  15. Jose Carlos Pastor 2
  16. Anna Sala 2
  1. 1 Universidade Do Porto
    info

    Universidade Do Porto

    Oporto, Portugal

    ROR https://ror.org/043pwc612

  2. 2 Universidad de Valladolid
    info

    Universidad de Valladolid

    Valladolid, España

    ROR https://ror.org/01fvbaw18

  3. 3 Tel Aviv Sourasky Medical Center
    info

    Tel Aviv Sourasky Medical Center

    Tel Aviv, Israel

    ROR https://ror.org/04nd58p63

  4. 4 Hospital Universitario Pío del Río Hortega
    info

    Hospital Universitario Pío del Río Hortega

    Valladolid, España

    ROR https://ror.org/05jk45963

  5. 5 Hospital Clinic Barcelona
    info

    Hospital Clinic Barcelona

    Barcelona, España

    ROR https://ror.org/02a2kzf50

  6. 6 Complejo Hospitalario Universitario de Albacete
    info

    Complejo Hospitalario Universitario de Albacete

    Albacete, España

    ROR https://ror.org/04a5hr295

  7. 7 Complejo Asistencial Universitario de Palencia
    info

    Complejo Asistencial Universitario de Palencia

    Palencia, España

    ROR https://ror.org/02atpex25

  8. 8 Clínica Universitaria de Navarra
    info

    Clínica Universitaria de Navarra

    Pamplona, España

    ROR https://ror.org/03phm3r45

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Revista:
Journal of Clinical & Experimental Ophthalmology

ISSN: 2155-9570

Año de publicación: 2015

Volumen: 06

Número: 04

Tipo: Artículo

DOI: 10.4172/2155-9570.1000464 GOOGLE SCHOLAR

Otras publicaciones en: Journal of Clinical & Experimental Ophthalmology

Resumen

Objective: Proliferative vitreoretinopathy (PVR) is still one of the most serious complications of rhegmatogenousretinal detachment (RRD) because there is no effective treatment or prophylaxis. Tumor necrosis factor α (TNFα)has been implicated in the development of PVR. Thus, the blockade of this factor could reduce or prevent the onsetof PVR. However, systemic treatment with anti-TNFα has some risks and side effects, and the use of these drugs inthis situation is not yet justified. Therefore we sought an indirect approach to determine if systemic anti-TNFαprovided any protection against the development of PVR after RRD surgery. We attempted to estimate the rate ofRRD and PVR in patients who were treated systemically with anti-TNFα drugs because of autoimmune diseasesand who also had surgically-treated RRD.Methods: Nine centers participated in this retrospective, observational study of cases and controls. Two differentapproaches were used to find cases and controls. The records at five clinical centers of patients who were underanti-TNFα treatment for chronic inflammatory systemic diseases between January 2004 and 2014 were reviewed todetermine how many developed RRD. Additionally, the records in eight clinical centers of patients who underwentRRD surgery during this same period were reviewed to determine the numbers who were simultaneously receivinganti-TNFα treatment. Cases included patients treated with anti-TNFα treatment whereas controls were those whowere not under anti-TNFα treatment. Both patients and controls had systemic inflammatory disease. The mainoutcome measure was development of PVR after RRD surgery at three months follow-up.Results: A total of 8,017 medical records from nine different centers were reviewed. Among the 1,884 patientswith anti-TNFα treatment and 6,133 patients operated for primary RRD, only 3 controls and 1 case were identified.Conclusions: An insufficient number of patients were identified to allow any valid conclusion regarding ourhypothesis that systemic anti-TNFα therapy could reduce the onset of PVR after RRD surgery. Nevertheless, thisindirect approach could be useful for future research in PVR prevention