Traction retinal detachment is a major cause of blindness and occurs in a variety of conditions including trauma, diabetes, and other vascular conditions characterized by cellular proliferation. Vitreoretinal traction caused by massive periretinal proliferation (MPP), now proliferative vitreoretinopathy (PVR), is the leading cause of failure of surgery for rhegmatogenous retinal detachment; PVR is the result of continued proliferation of cells that exert new tractional forces within the eye. Many blinding conditions share the basic wound-healing response of cellular proliferation followed by cell contraction leading to traction retinal detachment. We have modified and developed a model of PVR in the rabbit. We now propose to investigate in the rabbit eye a series of drugs to follow the observations of other research related to steroids and 5-fluorouracil, as effective drugs for the prevention of PVR. Daunomycin was identified as a likely candidate and will be studied in detail by standard pharmacologic procedures (dose-response curves, retinotoxicity, pharmacokinetics and metabolism, effectiveness in combination with vitrectomy). Other cytotoxic drugs will be screened for effectiveness, first in in vitro, then in in vivo experiments. The most efficacious drugs will be evaluated in the manner outlined for daunomycin.
