Intravitreal Decorin as an Adjuvant Therapy to Prevent Proliferative Vitreoretinopathy in Perforating Injuries: A Pilot Study



To determine the safety, tolerability, and efficacy of human recombinant decorin protein, a transforming growth factor ß (TGFß) inhibitor in preventing proliferative vitreoretinopathy (PVR) in patients with perforating globe injuries.


This is a prospective, single-center, open-label, interventional case series. A single intravitreal injection of decorin 200ug (n=4) or 400ug (n=8) was given within 24 hours of injury. Pars plana vitrectomy with silicone oil injection was done whenever indicated. Clinical assessment done during the study period (6 months) included best corrected visual acuity (BCVA), globe survival, retinal attachment rate, and PVR evaluation. Flash electroretinogram (ERG) was done before injections, and at day 10, and 3 months post injections.


Twelve patients (12 eyes) with perforating globe injuries (Zone III) with BCVAs light perception or better were included. Patients with mean age of 24.5±6.09 years (range: 18-40) were followed for a median of 6 months. Intravitreal decorin injection was well tolerated with no ocular or systemic safety adverse events noted at either dose. Flash ERG didn’t show any significant worsening during the study. Final BCVA ≥20/200 was achieved in 75%, final retinal attachment rate was 75%, PVR rate was 25%, and globe survival rate was 87.5%.


No safety concerns were detected after a single intravitreal injection of decorin (200-400ug) in patients with perforating injuries. The intravitreal injections showed relatively good efficacy warranting further investigating decorin as an antifibrotic agent.



Mahmoud Soliman
Cairo, Egypt
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