A comparison of 5-Fluorouridine and 5-Fluorouracil in an experimental model for the treatment of vitreoretinal scarring

Ward, Thomas G.; Hartzer, Michael K.; Blumenkranz, Mark S.; Lin, Lishan

doi:10.3109/02713689309024621

Cited by 9 publications

(4 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Low-molecular-weight heparin (LMWH) is an anticoagulant that binds fibronectin, bFGF, PDGF, and other growth factors [65]. Animal studies have found some efficacy of 5-FU for the treatment of vitreoretinal scarring [66, 67], but results in human clinical trials have been mixed (Table 2) [68–70]. In one prospective, randomized, double-masked, placebo-controlled trial, 174 high-risk patients were randomized to receive 5-FU and LMWH ( n = 87) versus placebo ( n = 87) after primary vitrectomy for rhegmatogenous retinal detachment [68].…”

Section: 5-fluorouracil (5-fu) and Low-molecular-weight Heparin (mentioning

confidence: 99%

Mechanisms of Inflammation in Proliferative Vitreoretinopathy: From Bench to Bedside

Moysidis

Thanos

Vavvas

2012

Mediators of Inflammation

104

View full text Add to dashboard Cite

Proliferative vitreoretinopathy (PVR) is a vision-threatening disease and a common complication of surgery to correct rhegmatogenous retinal detachment (RRD). Several models of the pathogenesis of this disease have been described with some of these models focusing on the role of inflammatory cells and other models focusing on the role of growth factors and cytokines in the vitreous which come into contact with intraretinal and retinal pigment epithelial cells. New experiments have shed light on the pathogenesis of PVR and offer promising avenues for clinical intervention before PVR develops. One such target is the indirect pathway of activation of platelet-derived growth factor receptor alpha (PDGRα), which plays an important role in PVR. Clinical trials assessing the efficacy of 5-fluorouracil (5-FU) and low-molecular-weight heparin (LMWH), daunorubicin, and 13-cis-retinoic acid, among other therapies, have yielded mixed results. Here we review inflammatory and other mechanisms involved in the pathogenesis of PVR, we highlight important clinical trials, and we discuss how findings at the bench have the potential to be translated to the bedside.

show abstract

Section: 5-fluorouracil (5-fu) and Low-molecular-weight Heparin (mentioning

confidence: 99%

Mechanisms of Inflammation in Proliferative Vitreoretinopathy: From Bench to Bedside

Moysidis

Thanos

Vavvas

2012

Mediators of Inflammation

104

View full text Add to dashboard Cite

show abstract

“…276 In another study, 1 mg 5-FU was loaded onto a biodegradable polymer and implanted into the vitreous, and maintained for 14 days. In a rabbit PVR model, a single intravitreal injection of 1 mg 5-FU successfully prevented PVR formation in 41% of animals at 28 days.…”

Section: Fluoropyrimidinesmentioning

confidence: 99%

Special Adjuncts to Treatment

Wong¹,

Wong²

2013

Retina

View full text Add to dashboard Cite

“…Kon et al reported that single, short-term exposure to 5-FU significantly inhibited the proliferation of cultured human RPE cells ( 12 ). In experimental PVR models, 5-FU was sufficient in reducing vitreoretinal scarring and tractional retinal detachment ( 13 ). On the other hand, low molecular weight heparin (LMWH) has been proved to inhibit the proliferation of human scleral fibroblasts and RPE cells, as well as the cell-mediated traction of collagen gel in vitro ( 14 ).…”

Section: Introductionmentioning

confidence: 99%

Combined 5-Fluorouracil and Low Molecular Weight Heparin for the Prevention of Postoperative Proliferative Vitreoretinopathy in Patients With Retinal Detachment: A Meta-Analysis

Chen

Liu

et al. 2021

Front. Med.

View full text Add to dashboard Cite

Background: Postoperative proliferative vitreoretinopathy (PVR) remains a dilemma for retinal surgeons. We performed a literature search and meta-analyses to figure out whether combined 5-fluorouracil (5-FU) and low molecular weight heparin (LMWH) treatment were effective in improving the primary success of vitrectomy and preventing postoperative PVR occurrence in patients with retinal detachment (RD).Methods: Databases including PubMed, Embase, the Cochrane library, and China National Knowledge Infrastructure (CNKI) were searched from inception to May 2021. Comparative studies approaching the effects of combined 5-FU and LMWH on postoperative PVR were included. Quality assessment was performed using RoB 2 and ROBINS-I tool. Study data were pooled using Review manager 5.4.1. The main outcomes were: the primary success of vitrectomy at 6 months and the postoperative PVR occurrence. The additional outcomes were: number of patients who underwent vitreoretinal reoperations and the number of vitreoretinal reoperations due to postoperative PVR. Subgroup analyses and sensitivity analyses were also performed.Results: Six clinical trials with a total of 1,208 participants were included. We found that combined 5-FU and LMWH infusion did not improve the primary success of vitrectomy at 6 months (RR = 1.00, 95% CI = 0.95, 1.07, P = 0.89, I2 = 50%). Also, the conjunct therapy had no effect on reducing the number of patients who underwent vitreoretinal reoperations (RR = 1.00, 95% CI = 0.78, 1.28, P = 1.00, I2 = 42%). The overall effect of the treatment on preventing postoperative PVR was negative. However, in patients with PVR grade C (PVRC) before intervention, the 5-FU and LMWH treatment significantly reduced PVR occurrence. Visual acuity was not different between the treatment and control groups. Nevertheless, in one RCT, a significant reduction of VA was observed in the treatment group in macular-sparing patients with RD. No complications were attributed to the conjunct therapy.Conclusions: The combined 5-FU and LMWH treatment neither improved the primary success of vitrectomy at 6 months nor decreased number of patients who underwent vitreoretinal reoperations. Thus, the treatment should not be routinely used in vitrectomy for patients with RD. However, the treatment proved beneficial in reducing postoperative PVR in patients with PVRC before intervention. More high-quality clinical trials are needed to confirm the results.Systematic Review Registration:https://inplasy.com/inplasy-2021-8-0117/, identifier: INPLASY202180117.

show abstract

A comparison of 5-Fluorouridine and 5-Fluorouracil in an experimental model for the treatment of vitreoretinal scarring

Cited by 9 publications

References 6 publications

Mechanisms of Inflammation in Proliferative Vitreoretinopathy: From Bench to Bedside

Mechanisms of Inflammation in Proliferative Vitreoretinopathy: From Bench to Bedside

Special Adjuncts to Treatment

Combined 5-Fluorouracil and Low Molecular Weight Heparin for the Prevention of Postoperative Proliferative Vitreoretinopathy in Patients With Retinal Detachment: A Meta-Analysis

Contact Info

Product

Resources

About