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

doi:10.1136/bjophthalmol-2018-312839

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 journal › Article › peer-review

14 Scopus citations

Abstract

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 language	English
Pages (from-to)	1306-1313
Number of pages	8
Journal	British Journal of Ophthalmology
Volume	103
Issue number	9
DOIs	https://doi.org/10.1136/bjophthalmol-2018-312839
State	Published - 1 Sep 2019
Externally published	Yes

Keywords

accutane
epiretinal membrane
retinal detachment
scleral buckle
vitrectomy

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10.1136/bjophthalmol-2018-312839

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London, N. J. S., Kaiser, R. S., Khan, M. A., Alshareef, R. A., Khuthaila, M., Shahlaee, A., Obeid, A., London, V. A., Decroos, F. C., Gupta, O. P., Hsu, J., Vander, J. F., Spirn, M. J., & Regillo, C. D. (2019). Determining the effect of low-dose isotretinoin on proliferative vitreoretinopathy: The DELIVER trial. British Journal of Ophthalmology, 103(9), 1306-1313. https://doi.org/10.1136/bjophthalmol-2018-312839

@article{05f069bb99ed4a42b2157e946b0d6fa0,

title = "Determining the effect of low-dose isotretinoin on proliferative vitreoretinopathy: The DELIVER trial",

abstract = "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.",

keywords = "accutane, epiretinal membrane, retinal detachment, scleral buckle, vitrectomy",

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

note = "Publisher Copyright: {\textcopyright} 2019 Author(s).",

year = "2019",

month = sep,

day = "1",

doi = "10.1136/bjophthalmol-2018-312839",

language = "English",

volume = "103",

pages = "1306--1313",

journal = "British Journal of Ophthalmology",

issn = "0007-1161",

publisher = "BMJ Publishing Group",

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London, NJS, Kaiser, RS, Khan, MA, Alshareef, RA, Khuthaila, M, Shahlaee, A, Obeid, A, London, VA, Decroos, FC, Gupta, OP, Hsu, J, Vander, JF, Spirn, MJ & Regillo, CD 2019, 'Determining the effect of low-dose isotretinoin on proliferative vitreoretinopathy: The DELIVER trial', British Journal of Ophthalmology, vol. 103, no. 9, pp. 1306-1313. https://doi.org/10.1136/bjophthalmol-2018-312839

TY - JOUR

T1 - Determining the effect of low-dose isotretinoin on proliferative vitreoretinopathy

T2 - The DELIVER trial

AU - London, Nikolas J.S.

AU - Kaiser, Richard S.

AU - Khan, Mohammed Ali

AU - Alshareef, Rayan A.

AU - Khuthaila, Mohammed

AU - Shahlaee, Abtin

AU - Obeid, Anthony

AU - London, Vanessa A.

AU - Decroos, Francis Char

AU - Gupta, Omesh P.

AU - Hsu, Jason

AU - Vander, James F.

AU - Spirn, Marc J.

AU - Regillo, Carl D.

PY - 2019/9/1

Y1 - 2019/9/1

N2 - 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.

AB - 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.

KW - accutane

KW - epiretinal membrane

KW - retinal detachment

KW - scleral buckle

KW - vitrectomy

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U2 - 10.1136/bjophthalmol-2018-312839

DO - 10.1136/bjophthalmol-2018-312839

M3 - Article

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AN - SCOPUS:85056083468

SN - 0007-1161

VL - 103

SP - 1306

EP - 1313

JO - British Journal of Ophthalmology

JF - British Journal of Ophthalmology

IS - 9

ER -

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

Abstract

Keywords

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