Pathophysiology of proliferative vitreoretinopathy in retinal detachment

Garweg, Justus G.; Tappeiner, Christoph; Halberstadt, Markus (2013). Pathophysiology of proliferative vitreoretinopathy in retinal detachment. SURVEY OF OPHTHALMOLOGY, 58(4), pp. 321-329. Elsevier 10.1016/j.survophthal.2012.12.004

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Because proliferative vitreoretinopathy cannot be effectively treated, its prevention is indispensable for the success of surgery for retinal detachment. The elaboration of preventive and therapeutic strategies depends upon the identification of patients who are genetically predisposed to develop the disease, as well as upon an understanding of the biological process involved and the role of local factors, such as the status of the uveovascular barrier. Detachment of the retina or vitreous activates glia to release cytokines and ATP, which not only protect the neuroretina but also promote inflammation, retinal ischemia, cell proliferation, and tissue remodeling. The vitreal microenvironment favors cellular de-differentiation and proliferation of cells with nonspecific nutritional requirements. This may render a pharmacological inhibition of their growth difficult without causing damage to the pharmacologically vulnerable neuroretina. Moreover, reattachment of the retina relies upon the local induction of a controlled wound-healing response involving macrophages and proliferating glia. Hence, the functional outcome of proliferative vitreoretinopathy will be determined by the equilibrium established between protective and destructive repair mechanisms, which will be influenced by the location and the degree of damage to the photoreceptor cells that is induced by peri-retinal gliosis.

Item Type:

Journal Article (Review Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Ophthalmology

UniBE Contributor:

Garweg, Justus; Tappeiner, Christoph and Halberstadt, Markus

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0039-6257

Publisher:

Elsevier

Language:

English

Submitter:

Christoph Tappeiner

Date Deposited:

03 Mar 2014 14:48

Last Modified:

17 Apr 2014 10:16

Publisher DOI:

10.1016/j.survophthal.2012.12.004

PubMed ID:

23642514

URI:

https://boris.unibe.ch/id/eprint/42862

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