Antiproliferative effect of retinoic acid in 1% sodium hyaluronate in an animal model of PVR

Abstract

PURPOSE. To determine the antiproliferative activity of intravitreous retinoic acid (RA) dispersed in 1% sodium hyaluronate (HA). METHODS. Six groups of pigmented rabbits underwent gas-compression vitrectomy. Four days later, gas/HA or gas/balanced salt solution (BSS) exchange (1.0 ml) was performed in all rabbits. Groups A (n = 10) and B (n = 5) received intravitreous RA dissolved in 0.01 ml of ethanol and dispersed in 1% HA (10 and 15 µg RA/ml, respectively). Group C (n = 10) received intravitreous RA dissolved in ethanol and dispersed in BSS (10 µg RA/ml). Groups D (n = 5) and F (n = 4) received 1 ml of HA with ethanol; group E (n = 5) received 1 ml of HA without ethanol. All groups except group F also received homologous fibroblasts and autologous, platelet-rich plasma intravitreously. The eyes were examined ophthalmoscopically for 1 month. Proliferative vitreoretinopathy (PVR) findings were graded according to the classification of Fastenberg et al. All group F eyes also were examined by light and electron microscopy. RESULTS. RA in HA lessened PVR progression within 1 month when compared with HA injection controls and within 2 weeks when compared with the RA in BSS treatment group (both, p < 0.05). No specific change attributable to ethanol was observed histopathologically. CONCLUSION. RA dissolved in ethanol and dispersed in HA could be useful to treat PVR when silicone oil is unnecessary.