[Efficacy of 5-fluorouracil polyactic acid microsphere in prevention of proliferative vitreoretinopathy]
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Published on: January 25, 2019
Hong-sheng Bi1, Yan Cui, Jian-hua Zhang
1Jinan Shierming Eye Hospital, Jinan 250002, China.
Objective:
To evaluate the efficacy of 5-fluorouracil polyactic acid microsphere in prevention of proliferative vitreoretinopathy (PVR).
Methods:
5-fluorouracil polyactic acid microsphere or 5-fluorouracil were used to implant into rabbits vitreous cavity. 48 healthy rabbits were divided into 3 groups: rabbits in Group 1 received implantation of 5-fluorouracil polyactic acid microsphere; rabbits Group 2 served as polyactic acid microsphere control; rabbits in Group 3 received only 5-fluorouracil powder. Macrophages were injected into vitreous cavity of rabbit to induce PVR. 0.2 ml BSS containing 25 mg microsphere with 2.6 mg 5-fluorouracil was injected into vitreous cavity of two eyes in Group 1. 0.2 ml BSS containing 25 mg microsphere without medicine and 0.2 ml BSS containing 2.6 mg 5-fluorouracil were injected into rabbits vitreous cavity in Group 2 and 3 respectively, Drug content in aqueous humor was measured regularly. Release feature of 5-fluorouracil polyactic acid microsphere in vivo was observed. The efficacy of the inhibition of PVR was evaluated according to Ryan's grade of proliferative vitreoretinopathy.
Results:
The releasing time of 5-fluorouracil polyactic acid microsphere was much longer than 5-fluorouracil powder. Its half life T(1/2) was 379.05 h with low clearance rate. The attack rate of retinal detachment in Group 2 was 62.5% and 71.9% on the 21st and 28th day respectively. The attack rate of retinal detachment in Group 3 was 64.3% and 78.6% whereas that of Group 1 was 13.3% and 13.3% on the 21st and 28th day. There was statistical difference in retinal detachment rate in Group 1 and 2 or 3 (P < 0.01). No differences was found in retinal detachment ration in Group 2 and 3 (P > 0.05).
Conclusion:
Implantation of 5-fluorouracil polyactic acid microsphere into vitreous cavity can effectively prevent proliferative vitreoretinopathy induced by macrophages in rabbit model.
Insights
5-fluorouracil polyactic acid microsphere effectively prevents proliferative vitreoretinopathy (PVR) in a rabbit model. This sustained-release formulation significantly reduces retinal detachment rates compared to standard 5-fluorouracil.
Area of Science:
- Ophthalmology
- Biomaterials
- Pharmacology
Context:
- Proliferative vitreoretinopathy (PVR) is a major cause of vision loss after retinal detachment surgery.
- Current treatments for PVR have limitations, necessitating novel therapeutic strategies.
- 5-fluorouracil is a chemotherapeutic agent used off-label to inhibit PVR, but its short duration of action is a concern.
Purpose:
- To evaluate the efficacy of 5-fluorouracil polyactic acid microsphere in preventing PVR.
- To compare the sustained release of 5-fluorouracil from polyactic acid microspheres against immediate-release 5-fluorouracil powder in a rabbit model.
Summary:
- A rabbit model was used to induce PVR via macrophage injection.
- Rabbits received either 5-fluorouracil polyactic acid microsphere, polyactic acid microsphere alone, or 5-fluorouracil powder.
- The microsphere formulation demonstrated significantly lower retinal detachment rates (13.3%) compared to 5-fluorouracil powder (78.6%) and control groups (71.9%) at 28 days, with a prolonged drug release (half-life of 379.05 hours).
Impact:
- 5-fluorouracil polyactic acid microsphere offers a promising sustained-release approach for PVR prevention.
- This formulation could improve clinical outcomes by providing longer therapeutic drug levels in the vitreous cavity.
- Further research may lead to a more effective treatment for preventing vision-threatening PVR.
