Surgical management of fibrotic encapsulation of the fluocinolone acetonide implant in CAPN5-associated proliferative vitreoretinopathy
| Autor: | Vinit B. Mahajan, James C. Folk, Warren M. Sobol, Paul S. Tlucek |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2013 |
| Předmět: |
medicine.medical_specialty
Proliferative vitreoretinopathy Stage iv disease medicine.medical_treatment CAPN5 03 medical and health sciences 0302 clinical medicine Fluocinolone acetonide Fibrosis Ophthalmology Medicine Case Series 030304 developmental biology Surgical repair 0303 health sciences business.industry calpain-5 Capsule Immunosuppression Clinical Ophthalmology autosomal dominant neovascular inflammatory vitreoretinopathy fibrotic encapsulation medicine.disease ADNIV 3. Good health Retisert 030221 ophthalmology & optometry fluocinolone acetonide Implant business medicine.drug |
| Zdroj: | Clinical Ophthalmology (Auckland, N.Z.) |
| ISSN: | 1177-5483 1177-5467 |
| Popis: | Paul S Tlucek,1 James C Folk,1 Warren M Sobol,2 Vinit B Mahajan1,3 1Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa City, IA, USA; 2Retina Physicians and Surgeons, Dayton, OH, USA; 3Omics Laboratory, University of Iowa, Iowa City, IA, USA Objective: To review fibrosis of fluocinolone acetonide (FA) implants in subjects with CAPN5 autosomal dominant neovascular inflammatory vitreoretinopathy (ADNIV). Methods: A retrospective case series was assembled from ADNIV patients in which there was fibrotic encapsulation of a fluocinolone acetonide implant. CAPN5 genotypes and surgical repair techniques were reviewed. Results: Two eyes of two ADNIV patients developed a fibrotic capsule over the fluocinolone acetonide implant. Both patients had Stage IV disease. Patient A had a c.731T > C mutation in the CAPN5 gene and patient B had a c.728G > T mutation. The fibrotic membrane was surgically excised and the implant function was restored. Conclusion: The exuberant fibrotic response in later stages of ADNIV may be resistant to local immunosuppression with steroids. Surgical excision of fibrotic membranes over FA implants can reestablish local steroid delivery in cases of severe proliferative vitreoretinopathy. Keywords: autosomal dominant neovascular inflammatory vitreoretinopathy, ADNIV, CAPN5, calpain-5, Retisert, fluocinolone acetonide, fibrotic encapsulation |
| Databáze: | OpenAIRE |
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