Proliferative Vitreoretinopathy in Rhegmatogenous Retinal Detachment

Disease or general study area: Uncomplicated rhegmatogenous retinal detachment (RRD) and risk of proliferative vittroretinopathy (PVR) Purpose and nature of the study: 1. Characterise the cytokine profile of vitreous fluid in uncomplicated RRD. 2. Develop a risk model to predict development of PVR after retinal detachment surgery using imaging and molecular biomarkers. 3. To develop deep learning/artificial intelligence (AI) models for PVR detection in retinal detachment. Inclusion criteria: 50 adult ( ≥18 years) patients with uncomplicated rhegmatogenous retinal detachments without PVR. What participating will involve: Pre- and post-operative assessments and intervention will follow standard of care for patients with rhegmatogenous retinal detachments. Additional intervention will include non-invasive imaging of anterior chamber flare, vitreous, wide-field retina, macula optical coherence tomography (OCT) and macula OCT-angiography (OCT-A) as well as, seeking participant's consent on collecting their vitreous fluid at time of their surgery for cytokine analysis.

Intravitreal topotecan has anti-inflammatory, anti-proliferative and anti-fibrotic activity that we hypothesize may exhibit high efficacy for the treatment of proliferative vitreoretinopathy (PVR) in patients with rhegmatogenous retinal detachment (RRD). A high efficacy for intravitreal topotecan has been exhibited in cell cultures of PVR. At the same time, intravitreal topotecan has been routinely used in the treatment of vitreous seeds from retinoblastoma. At doses of 5-30 micrograms per injection, no adverse events have been reported with the use of intravitreal topotecan. Therefore, the current prospective matched phase II trial aims to investigate the efficacy and safety of intravitreal topotecan for severe PVR in patients with RRD.