Proliferative vitreoretinopathy (PVR) is a still incompletely defined term for a pathological process that occurs after retinal detachment and subsequent surgical treatment [1] [2]. Namely, PVR is predominantly described as the most common cause of surgical failure for rhegmatogenous retinal detachment (RRD) [1] [3], in which the detached retina creates a space for fluid to accumulate between the retinal pigment epithelium and the neurosensory component of this structure. The complete pathogenesis model is still not understood, but it is assumed that after retinal detachment (predominantly caused by trauma) and penetration of the blood-retina-barrier (RBB), local cells promote an inflammatory reaction by secreting various cytokines that aid in the process of healing [1] [4] [5]. More importantly, migration of various cell lineages is induced, including fibroblasts, polymorphonuclear leukocytes, lymphocytes, but also glial cells [1] [4]. These cells accumulate in the previous location of the retina, and in the attempt to repair retinal detachment, abnormal healing leads to the formation of scar tissue [1] [5]. Because no viable retinal tissue is formed, even after successful surgical treatment, patients suffer from reduced visual acuity that develops approximately a few months after the initial retinal detachment [1] [6] [7] [8]. Various intrinsic factors (severity of detachment, delay in diagnosis, the presence of vitreous hemorrhage, macular involvement, etc.) determine the extent of visual symptoms and the prognosis [1] [7] [9]. Furthermore, various studies have confirmed the recurrent nature of proliferative vitreoretinopathy, even after multiple surgeries [1] [9].

• Severe Clinical Course

  The early onset and the severe clinical course of proliferative vitreoretinopathy in these eyes showed parallels to traumatic proliferative vitreoretinopathy. The retina in all eyes could be reattached. [ncbi.nlm.nih.gov]

• Rubeosis Iridis

  No patients developed rubeosis iridis related to the total retinectomy. [ncbi.nlm.nih.gov]

• Ulcer

  Langenbach R, Morham SG, Tiano HF et al (1995) Prostaglandin synthase 1 gene disruption in mice reduces arachidonic acid-induced inflammation and indomethacin-induced gastric ulceration. Cell 83:483–492 CrossRef PubMed Google Scholar 21. [doi.org]

• Fear

  This feared complication has been reported to occur in up to 8% of patients after undergoing RD repair. [ncbi.nlm.nih.gov]

• Irritability

  It has been suggested that the posterior lens capsule may protect the anterior uvea, the site of active transport, from mechanical and physical irritation by the vitreous gel in phakic eyes [ 10 ]. [systematicreviewsjournal.biomedcentral.com]

  […] that the outward active transport of fluorescein from the vitreous was reduced in aphakic compared with phakic eyes. 27 They suggested that the posterior lens capsule may protect the anterior uvea (site of active transport) from mechanical and physical irritation [doi.org]

  02 Method of preventing NMDA receptor-mediated neuronal damage AT401615B ( en ) 1996-10-25 Use of special 5HT3 antagonists for the manufacture of medicines US5686100A ( en ) 1997-11-11 Prophylactic and therapeutic treatment of skin sensitization and irritation [google.la]

  […] with functional antagonists of the glycine/NMDA receptor complex AT401615B ( en ) 1996-10-25 Use of special 5HT3 antagonists for the manufacture of medicines US5686100A ( en ) 1997-11-11 Prophylactic and therapeutic treatment of skin sensitization and irritation [google.sr]

Despite the fact that the pathophysiological mechanisms that determine the course of recovery after retinal detachment, many studies have identified that some of the risk factors that facilitate a poorer prognosis (eg. delayed recognition and initiation of treatment) are highly preventable [9], primarily by conducting a proper ophthalmological examination and follow-up after retinal detachment. Physicians must consider proliferative vitreoretinopathy in the differential diagnosis of progressive visual acuity disturbances and loss of vision in patients who underwent surgical treatment for retinal detachment, meaning that a meticulously obtained patient history is vital in the diagnostic workup. Visual acuity testing is mandatory in all patients, and after clinical suspicion is raised, a dilated fundus examination is often sufficient to detect proliferative vitreoretinopathy [8]. Slit-lamp biomicroscopy can provide an insight into the retinal pathology [1], but ocular endoscopy has become a valuable tool (among many diagnostic and therapeutic approaches, including ultrasonography, optical coherence tomography, angiography, etc.) in the assessment of the retina, the ciliary body, and the vitreous body [10].

• Foam Cell

  A histological examination revealed that the epiretinal membrane consisted of collagen fibers, glial proliferation, foam cells and lymphocytes. The foam cell in the epiretinal membrane is a characteristic finding in an eye with Coats' disease. [ncbi.nlm.nih.gov]

Both groups will receive the standard surgical treatment appropriate for their eye condition and routine peri-operative treatment and care, differing only in the addition of the supplementary adjunctive agent in the treatment group. [ncbi.nlm.nih.gov]

When the concentrations of IGFBP-6 or KNG1 were greater than 98.5 pg/ml or 88.5 ng/ml, respectively, they predicted the PVR prognosis with both a sensitivity and specificity of 80 per cent. [ncbi.nlm.nih.gov]

Prognosis of syphilitic uveitis after appropriate therapy is classically regarded as favorable. [joii-journal.springeropen.com]

Thus, the identification of this type of intraretinal PVR is crucial for planning surgery and it is important information for the prognosis for each patient. [touchophthalmology.com]

Generally, these have a poorer long-term prognosis for vision and successful surgical outcome despite the fact that they may be easier to peel intraoperatively than less mature, fresh membranes. [healio.com]

Various intrinsic factors (severity of detachment, delay in diagnosis, the presence of vitreous hemorrhage, macular involvement, etc.) determine the extent of visual symptoms and the prognosis. [symptoma.com]

Hambartsumyan Med Sci Monit 2000; 6(4): CR704-707 ID: 508170 The aim of the current study is the efficiency assessment of C3F8 gas usage in posterior vitrectomies in patients having retinal detachment of different etiologies with presence of proliferative [medscimonit.com]

Etiologic mechanisms in diabetic retinopathy. In: Ryan SJ, editor. Retina, vol II. St Louis: CV Mosby, 1989:301–26. 27 Sheiki D, Itin A, Soffer D, Keshet E. [nature.com]

Dis. ... dokt. med. nauk [The role of vitrectomy in treatment of eye diseases of traumatic, degenerative and inflammatory etiology. DSc Thesis]. Moscow; 1987. 8. Zakharov V.D., Sharipova D.N., Shatskikh A.V. [cyberleninka.ru]

Keywords: Osteoporosis/complications; Vitreoretinopathy, proliferative; Retinopathy of prematurity; Eye diseases, hereditary/etiology; Fluorescein angiography; Fundus oculi; Visual acuity; Vitreous body/surgery; Retinal detachment; Human; Female; Child [scielo.br]

Laatikainen L, Tolppanen EM, Harju H: Epidemiology of rhegmatogenous retinal detachment in a Finnish population. Acta Ophthalmol 1985;63:59-64. [karger.com]

Nicholson BP, Zhou M, Rostamizadeh M et al (2014) Epidemiology of epiretinal membrane in a large cohort of patients with uveitis. Ophthalmology 121:2393–2398 CrossRef PubMed PubMedCentral Google Scholar 25. [doi.org]

Posttraumatic proliferative yitreoretinopathy: the epidemiologic profile, onset, risk factors, and visual outcome. Ophthalmology 1997; 104 : 1166–1173 15 Sobaci G, Mutlu FM, Bayer A, Karagui S, Yildirim E. [nature.com]

EPIDEMIOLOGY AND PATHOGENESIS PVR occurs following surgical repair of retinal detachment but can develop in untreated cases, particularly those that are long-standing or with large breaks. [medtextfree.wordpress.com]

Epidemiology Frequency United States Of all retinal detachment surgery cases, 5-10% develop proliferative vitreoretinopathy. [8] International Worldwide incidence is the same as that in the United States. [emedicine.medscape.com]

Further study is needed to understand the pathophysiologic mechanisms underlying this correlation. [ncbi.nlm.nih.gov]

Intravitreal injection of LY prevented tractional retinal detachment in 14 out of 15 animals. [ncbi.nlm.nih.gov]

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