Clinical therapeutics for proliferative vitreoretinopathy in retinal detachment.
Autor: | Sabatino F; Vitreoretinal Service, Norfolk and Norwich University Hospitals NHS Foundation Trust, Colney Lane, Norwich NR4 7UY, United Kingdom., Banerjee P; Frimley Park Hospital, Frimley Health NHS Foundation Trust, Portsmouth Road, Camberley, Surrey GU16 7UJ, United Kingdom., K Muqit MM; Department of Vitreoretinal Surgery, Moorfields Eye Hospital NHS Foundation Trust, City Road, London EC1V 2PD, United Kingdom; Institute of Ophthalmology, University College London, United Kingdom. Electronic address: mahi.muqit1@nhs.net. |
---|---|
Jazyk: | angličtina |
Zdroj: | Survey of ophthalmology [Surv Ophthalmol] 2024 Jul-Aug; Vol. 69 (4), pp. 508-520. Date of Electronic Publication: 2024 Mar 15. |
DOI: | 10.1016/j.survophthal.2024.03.007 |
Abstrakt: | Proliferative vitreoretinopathy (PVR) is an abnormal and prolonged healing response to retinal injury (retinal detachment, post retinal detachment surgery) characterised by: pre/subretinal membrane formation; retinal gliosis and retinal shortening, retinal pigment epithelium cell proliferation; and increased glial (mainly Mu¨ller cells), fibroblast and inflammatory cell (macrophage, lymphocyte) activity, leading to tractional retinal holes/breaks and multiple costly eye operations suffered by patients. PVR can cause retinal re-detachment following primary surgical intervention for rhegmatogenous retinal detachment. Vitrectomy and scleral buckling surgery are the main approaches for treating PVR complications of retinal detachment. Patients require many operations to remove the scar tissue but vision results are suboptimal, and do not meet patient expectations. Over the past 40 years, this has been one of the greatest challenges for vitreoretinal surgeons and patients. Despite previous large clinical trials of multiple candidate drug therapeutics, no proven adjunctive treatment currently exists to either prevent, reduce, or treat PVR formation in retinal detachment. Both cellular proliferation and the intraocular inflammatory response are realistic targets for adjunctive treatments in PVR. The cellular components of PVR periretinal membranes (retinal pigment epithelial, glial, inflammatory and fibroblastic cells) proliferate and are thus targets for antiproliferative agents. In recent years, several new therapeutics have been tested, and we present an updated review of the clinical therapeutics for PVR in retinal detachment. Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. (Copyright © 2024 Elsevier Inc. All rights reserved.) |
Databáze: | MEDLINE |
Externí odkaz: |