Infliximab may improve visual acuity in PVR associated with RRD
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SEATTLE — Patients with proliferative vitreoretinopathy experienced improved visual acuity after receiving an intravitreal injection of infliximab after pars plana vitrectomy, according to a study.
At the American Society of Retina Specialists annual meeting, Ayman Elnahry, MD, PhD, said proliferative vitreoretinopathy (PVR) is the most common cause of failure of rhegmatogenous retinal detachment (RRD) repair.
“Multiple therapeutic agents have been tried as an adjunctive to RRD surgery with no consistent efficacy, and there are currently no medications approved for treating PVR,” he said.
In the phase 2 randomized controlled FIXER trial, Elnahry and colleagues evaluated the safety and efficacy of intravitreal infliximab for the treatment of PVR associated with RRD when given after pars plana vitrectomy and silicone oil injection. Thirty eyes received infliximab at the conclusion of pars plana vitrectomy, and 30 eyes did not receive infliximab.
The primary outcome measure was final anatomic success, which was defined as complete retinal reattachment without tamponade at 6 months after silicone oil removal. Secondary outcome measures included final best correct visual acuity, single operation success rate, rate of recurrent RRD, and macular thickness, function and vascular density.
The 30 eyes in the infliximab group and 29 eyes in the control group met the primary outcome measure of anatomic success. The single operation success rate was higher in the infliximab group, but the difference was not statistically significant.
The final BCVA was better in the infliximab group than in the control group (P = .044). Elnahry said this could be due to a lower rate of recurrent retinal detachment in the infliximab group.
“Intravitreal infliximab has been used in several conditions, and there is some concern of inflammation with it,” Elnahry said. “However, we did not observe this in our study. Our conclusion is that it is safe and effective in the treatment of PVR.”
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Elnahry A. Intravitreal infliximab for the treatment of proliferative vitreoretinopathy associated with rhegmatogenous retinal detachment: The phase 2 FIXER trial. Presented at: American Society of Retina Specialists annual meeting; July 28-Aug. 1, 2023; Seattle.
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