Intravitreal Infliximab for Proliferative Vitreoretinopathy
Status:
Not yet recruiting
Trial end date:
2023-11-10
Target enrollment:
Participant gender:
Summary
Proliferative vitreoretinopathy (PVR) is the most common cause for failure of rhegmatogenous
retinal detachment repair and is characterized by the growth and contraction of cellular
membranes within the vitreous cavity on both sides of the retinal surface as well as
intraretinal fibrosis.
Multiple therapeutic agents have been tried as an adjunctive to retinal detachment surgery
for PVR with no consistent efficacy. Tumor necrosis factor-α (TNF-α), which is a prominent
inflammatory cytokine, is secreted in response to trauma, infection, and inflammation. It is
a key mediator of ocular inflammation and its interactions with the retinal pigment
epithelium (RPE) cell contribute to the initiation of PVR. This may occur through the action
of TNF-α on the RPE cells inducing changes in cellular morphologies that lead to the
formation of fibroblastic cells.
Infliximab (Remicade; Janssen Biotech, Horsham, PA, USA) is a mouse-human chimeric antibody
that neutralizes the biological activity of TNF-α by high-affinity binding to the soluble and
transmembrane forms of TNF-α, therefore preventing the effective binding of TNF-α with its
receptors. Infliximab is used in the treatment of various ocular and systemic inflammatory
conditions. Furthermore, intravitreal infliximab has been used for the treatment of various
ocular diseases and has proven to be generally safe for the short term in inflammatory ocular
conditions. A recent study showed that intravitreal infliximab can inhibit the development of
PVR and reduce levels of cytokines in an experimental dispase-induced PVR model.
The purpose of this randomized controlled trial is to evaluate the efficacy of intravitreal
infliximab injection as an adjunct to pars plana vitrectomy in the treatment of PVR
associated with primary rhegmatogenous retinal detachment.