Ari DJATIKUSUMO, Andi Arus VICTOR, Rina La Distia NORA, Heri WIBOWO, Seruni Hanna ARDHIA
Retina-Vitreus - 2026;35(2):145-151
Purpose: To determine whether short-term preoperative topical nepafenac 0.1% reduces vitreous inflammatory biomarkers in patients with rhegmatogenous retinal detachment (RRD) and early proliferative vitreoretinopathy (PVR). Methods: A randomized, double-masked, clinical trial study was done, with a total of 61 subjects, which were allocated to 31 subjects in nepafenac 0.1% group and 30 subjects in the control group. The subjects included were RRD patients with PVR A or B, scheduled for vitrectomy. Vitreous samples were collected during vitrectomy and vitreous biomarker levels (PGE2, COX-2, TGF-beta, and monocytes) of each group were analysed. Results: No statistically significant differences were observed between nepafenac and control groups. The mean (Standard Deviation [SD]) of PGE2 was 89.38 pg/mL in the nepafenac 0.1% group and 91.77 pg/mL in the control group. The median (range) COX-2 in the nepafenac group and control group was 1.47 (1.27-1.57) ng/mL and 1.32 (1.25-1.55) ng/mL, respectively; TGF-beta was 43.69 (8.01-229.06) pg/mL and 51.83 (15.61-319.58) pg/mL, respectively; and monocytes (comparison of CD14 and CD45) was 86.79 (46.5-96.51) % and 90.25 (24.85-95.24) %, respectively. Conclusion: Short-term preoperative topical nepafenac does not significantly modulate vitreous inflammatory biomarkers in early PVR. These findings suggest that targeting the COX-prostaglandin pathway alone may be insufficient to influence the complex inflammatory-fibrotic cascade underlying PVR.
