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].

• Inflammation

  Inflammation happened in the pathological processes of RRD, and proliferation mainly happened during PVR formation. [ncbi.nlm.nih.gov]

  Conclusion: Eyes at high risk for PVR development due to a history of prior PVR or intraocular inflammation had a low incidence of PVR following IMI at the time of PPV for RD repair. [dovepress.com]

  Kapin MA, Yanni JM, Brady MT et al (2003) Inflammation-mediated retinal edema in the rabbit is inhibited by topical nepafenac. Inflammation 27:281–291 CrossRef PubMed Google Scholar 19. [doi.org]

• Surgical Procedure

  Discusses post-operative care and potential complications of each surgical procedure, preparing you for any challenges you may face. [books.google.com]

  PURPOSE: As some surgical procedures have been shown to increase postoperative flare values and thus contribute to blood-ocular barrier breakdown, retinal reattachment surgery might influence the risk of developing proliferative vitreoretinopathy (PVR [ncbi.nlm.nih.gov]

  Procedures and Postoperative Cases Toxic Retinopathies; see also Light Toxicitiy Trauma (Injury) Tumors, Neoplasma Vascular Diseases (see also: Systemic Immunologic Diseases) Sclera Strabismus, Ocular Motility Disorders Systemic Diseases Vitreous Z Videos [atlas-of-ophthalmology.com]

• Falling

  Proliferative Vitreoretinopathy (PVR) occurs when a scar forms under or on the retina after retinal detachment, preventing the retina from healing and falling back into place. ( Find out more about retinal detachment ). [snec.com.sg]

  No falls or trauma. No other eye surgeries. No family history of retinal detachments. [webeye.ophth.uiowa.edu]

  These are opaque and block the light falling on the retina so the retinal reattachment surgery needs to be performed after manually peeling the membrane off.[10][11] Cytokines involved in PVR[edit] A number of cytokines such as tumor necrosis factor alpha [en.wikipedia.org]

• Weakness

  The findings will be discussed in the context of the strengths and weaknesses of both the review methods and the available evidence. This will include a discussion of the likely impact of any ongoing research on the review findings. [systematicreviewsjournal.biomedcentral.com]

  A large-scale randomized controlled trial has shown a weak beneficial effect for perioperative daunomycin.[25] A combination of adjuvant 5-hydroxyuracil and low-molecular-weight heparin has been shown to reduce the incidence of PVR in high-risk cases [medtextfree.wordpress.com]

• Osteoporosis

  The inflammatory potential of drugs used in the control of the osteoporosis, in contrast with the inherent inflammatory activity the disease, are discussed. [scielo.br]

  @article{Neto2009FamilialEV, title={Familial exudative vitreoretinopathy (FEVR) associated with infantile osteoporosis: case report.}, author={Laurentino Biccas Neto and Arthur Silva de Mesquita and Iuri Drumond Louro}, journal={Arquivos brasileiros de [semanticscholar.org]

• Anterior Uveitis

  Randomized Phase 2 Trial of Reproxalap, a Novel Reactive Aldehyde Species Inhibitor, in Patients with Noninfectious Anterior Uveitis: Model for Corticosteroid Replacement. Mandell KJ, Clark D, Chu DS, Foster CS, Sheppard J, Brady TC. [pubmed.ncbi.nlm.nih.gov]

  An equation to calculate the patient's risk for acquiring PVR is: PVR score = 2.88 × (Grade C PVR)+ 1.85 × (Grade B PVR) + 2.92 × (aphakia) + 1.77 × (anterior uveitis) + 1.23 × (quadrants of detachment) + 0.83 × (vitreous haemorrhage) + 23 × (previous [en.wikipedia.org]

  Nongranulomatous anterior uveitis associated with alendronate therapy. [scielo.br]

• Confusion

  […] retinoschisis rarely present with symptoms because of their peripheral location. [1] Sometimes, however, advanced cases may present with a large peripheral visual field defect corresponding to the area of retinoschisis and in some cases, it could be confused [ijcasereportsandimages.com]

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].

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]

Proliferative vitreoretinopathy (PVR) is a still incompletely defined term for a pathological process that occurs after retinal detachment and subsequent surgical treatment. [symptoma.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]

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]

Pathophysiology Add text here Primary prevention Add text here Add text here Clinical Appearance Add text here Differential diagnosis Add text here Add text here Surgical treatment Add text here Medical therapy Add text here Complications Add text here Prognosis [eyewiki.aao.org]

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]

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

Add text here Disease Add text here Etiology Add text here Classification staging XXX Risk Factors Add text here General Pathology Add text here Pathophysiology Add text here Primary prevention Add text here Add text here Clinical Appearance Add text [eyewiki.aao.org]

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]

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]

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]

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]

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]

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]

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]

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]

Mortada and Salvatore Grisanti on Jun 27, 2017 in 08:30 – 10:50 Papers, 2-TRAUMA, 2017 EVRS Congress – Florence, 3-Saturday, September 16 | Comments Off on Intravitreal Decorin as an Adjuvant Therapy to Prevent Proliferative Vitreoretinopathy in Perforating [evrs.eu]

1. Sadaka A, Giuliari GP. Proliferative vitreoretinopathy: current and emerging treatments. Clin Ophthalmol. 2012;6:1325-1333.
2. Di Lauro S, Kadhim MR, Charteris DG, Pastor JC. Classifications for Proliferative Vitreoretinopathy (PVR): An Analysis of Their Use in Publications over the Last 15 Years. J Ophthalmol. 2016;2016:7807596.
3. Pastor JC. Proliferative vitreoretinopathy: an overview. Surv Ophthalmol. 1998;43(1):3–18.
4. Vinores SA, Campochiaro PA, Conway BP. Ultrastructural and electron-immunocytochemical characterization of cells in epiretinal membranes. Invest Ophthalmol Vis Sci. 1990;31(1):14–28
5. Garweg JG, Tappeiner C, Halberstadt M. Pathophysiology of proliferative vitreoretinopathy in retinal detachment. Surv Ophthalmol. 2013;58(4):321-329.
6. Mietz H, Heimann K. Onset and recurrence of proliferative vitreoretinopathy in various vitreoretinal disease. Br J Ophthalmol. 1995;79(10):874-877.
7. Sadeh AD, Dotan G, Bracha R, Lazar M, Loewenstein A. Characteristics and outcomes of paediatric rhegmatogenous retinal detachment treated by segmental scleral buckling plus an encircling element. Eye (Lond). 2001;15(Pt 1):31-33.
8. Schwartz SG, Flynn HW, Lee W-H, Ssemanda E, Ervin A-M. Tamponade in surgery for retinal detachment associated with proliferative vitreoretinopathy. Cochrane Database Syst Rev. 2009;(4): CD006126.
9. Tseng W, Cortez RT, Ramirez G, Stinnett S, Jaffe GJ. Prevalence and risk factors for proliferative vitreoretinopathy in eyes with rhegmatogenous retinal detachment but no previous vitreoretinal surgery. Am J Ophthalmol. 2004;137(6):1105-1115.
10. Boscher C, Kuhn F. An endoscopic overview of the anterior vitreous base in retinal detachment and anterior proliferative vitreoretinopathy. Acta Ophthalmol. 2014;92(4):e298-304.