Determining the effect of low-dose isotretinoin on proliferative vitreoretinopathy: The DELIVER trial

Nikolas J.S. London, Richard S. Kaiser, Mohammed Ali Khan, Rayan A. Alshareef, Mohammed Khuthaila, Abtin Shahlaee, Anthony Obeid, Vanessa A. London, Francis Char Decroos, Omesh P. Gupta, Jason Hsu, James F. Vander, Marc J. Spirn, Carl D. Regillo

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


Purpose To examine the effect of low-dose, oral isotretinoin in lowering the risk of proliferative vitreoretinopathy (PVR) following rhegmatogenous retinal detachment (RRD) repair. Methods Prospective, open label, dual-cohort study with pathology-matched historical controls. The prospective experimental arms included two cohorts, composed of 51 eyes with recurrent PVR-related RRD and 58 eyes with primary RRD associated with high-risk features for developing PVR. Eyes in the experimental arms received 20 mg of isotretinoin by mouth once daily for 12 weeks starting the day after surgical repair. The primary outcome measure was single surgery anatomical success rate at 3 months following the study surgery. Results The single surgery anatomic success rate was 78.4% versus 70.0% (p=0.358) in eyes with recurrent PVR-related retinal detachment exposed to isotretinoin versus historical controls, respectively. In eyes with RRD at high risk for developing PVR, the single surgery success rate was 84.5% versus 61.1% (p=0.005) for eyes exposed to isotretinoin versus historical controls, respectively. For eyes enrolled in the experimental arms, the most common isotretinoin-related side effects were dry skin/mucus membranes in 106 patients (97.2%), abnormal sleep/dreams in 4 patients (3.7%) and fatigue in 3 patients (2.8%). Conclusion The management and prevention of PVR is challenging and complex. At the dose and duration given in this study, oral istotretinoin may reduce the risk of PVR-associated recurrent retinal detachment in eyes with primary RRD at high risk of developing PVR.

Original languageEnglish
Pages (from-to)1306-1313
Number of pages8
JournalBritish Journal of Ophthalmology
Issue number9
StatePublished - 1 Sep 2019
Externally publishedYes


  • accutane
  • epiretinal membrane
  • retinal detachment
  • scleral buckle
  • vitrectomy


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