Our Summary

Rhegmatogenous retinal detachment (RD) is a severe eye condition that can lead to vision loss. Even after successful surgery to reattach the retina, complete vision recovery is not always possible. This is due to the build-up of fluid under the retina, which leads to the death of cells responsible for detecting light and color (photoreceptors).

This study investigated the use of ursodeoxycholic acid (UDCA), a type of bile acid, as a potential treatment for this condition. UDCA has been shown to protect nerve cells in animal models and is already approved for clinical use in other conditions.

The researchers gave oral UDCA to patients before RD surgery and found that the amount of UDCA in the eye correlated with the severity of the retinal detachment. They also found that UDCA, at the levels measured in the eye, protected photoreceptors from dying in rat retinas.

Moreover, the fluid collected from underneath the retina during surgery from patients who were treated with UDCA provided significant protection for rat retinas from cell death, compared to fluid from untreated patients.

Lastly, the researchers found that UDCA activated genes in the retina that combat cell death, oxidative stress, and inflammation.

In simpler terms, this study suggests that UDCA might protect the light-sensitive cells in the retina from damage and could potentially be used as a supplementary treatment in RD and other eye diseases that cause retinal damage. However, more research in clinical trials is needed to confirm these findings.

FAQs

  1. What is Rhegmatogenous retinal detachment (RD) and how does it affect vision?
  2. Can Ursodeoxycholic acid (UDCA) be used as a treatment for retinal diseases?
  3. How does UDCA work to protect the retina in the event of RD or other degenerative diseases?

Doctor’s Tip

One helpful tip a doctor might tell a patient about retinal surgery is to consider taking oral ursodeoxycholic acid (UDCA) before the surgery. Studies have shown that UDCA can protect photoreceptors from cell death and may help improve vision outcomes after retinal detachment surgery. It is important to discuss this potential treatment option with your doctor to see if it is appropriate for your specific situation.

Suitable For

Patients with rhegmatogenous retinal detachment (RD) are typically recommended retinal surgery. These patients may experience vision loss due to subretinal fluid accumulation and photoreceptor cell death. In this study, oral ursodeoxycholic acid (UDCA) was evaluated as a potential neuroprotective adjuvant therapy for patients undergoing RD surgery. UDCA was found to protect photoreceptors from cell death and upregulate anti-apoptotic, anti-oxidant, and anti-inflammatory genes in the retina. This suggests that oral UDCA may be beneficial for patients with RD and other retinal degenerative diseases, and further clinical trials are warranted.

Timeline

  • Before retinal surgery: The patient may experience symptoms such as vision loss, floaters, flashes of light, or a curtain-like shadow over their vision. They would undergo a comprehensive eye examination, including imaging tests like optical coherence tomography and ultrasound, to confirm the diagnosis of retinal detachment. The surgeon would explain the procedure, risks, and potential outcomes to the patient.

  • During retinal surgery: The patient would undergo a surgical procedure to reattach the detached retina, which may involve techniques such as scleral buckle, pneumatic retinopexy, or vitrectomy. The surgeon would drain the subretinal fluid, seal the retinal tear, and reattach the retina with laser or cryotherapy. The patient would be monitored closely during and after the surgery for any complications.

  • After retinal surgery: The patient would have a recovery period, during which they may experience symptoms like discomfort, redness, or blurred vision. They would need to follow post-operative instructions, including using eye drops, avoiding strenuous activities, and attending follow-up appointments. The surgeon would monitor the healing process and assess the visual acuity of the patient. In some cases, vision may improve gradually over time, while in others, it may remain stable or have some degree of permanent loss.

What to Ask Your Doctor

  1. How does retinal surgery work and what are the potential risks and complications?

  2. What is the success rate of retinal surgery in reattaching the retina and improving vision?

  3. How long is the recovery process after retinal surgery and what can I expect in terms of visual improvement?

  4. Are there any alternative treatments or therapies that could be beneficial in addition to retinal surgery?

  5. What is the role of oral UDCA in retinal surgery and how does it help protect photoreceptors?

  6. What is the recommended dosage and duration of oral UDCA treatment before and after retinal surgery?

  7. Are there any potential side effects or interactions of oral UDCA with other medications or health conditions?

  8. How will the effectiveness of oral UDCA be monitored during and after retinal surgery?

  9. Are there any specific lifestyle changes or precautions I should take to optimize the benefits of oral UDCA in protecting my retinal health?

  10. Are there any ongoing clinical trials or research studies investigating the use of oral UDCA for retinal degenerative diseases, and how can I stay informed about new developments in this area?

Reference

Authors: Daruich A, Jaworski T, Henry H, Zola M, Youale J, Parenti L, Naud MC, Delaunay K, Bertrand M, Berdugo M, Kowalczuk L, Boatright J, Picard E, Behar-Cohen F. Journal: Neurotherapeutics. 2021 Apr;18(2):1325-1338. doi: 10.1007/s13311-021-01009-6. Epub 2021 Feb 3. PMID: 33537951