Proliferative vitreoretinopathy: Advances in surgical management

摘要

A once debilitating disease, rhegmatogenous retinal detachment (RRD), with the help of modern surgical techniques, has become a treatable condition with success rates of >80% to 90%.1-3 Despite such successes, subsets of patients suffer from sudden retina redetachment and require reoperations. Proliferative vitreoretinopathy (PVR), a disease first described as massive vitreal retraction (MVR), is the leading cause of failed retinal detachment operations. Its name was first attributed to the retinal folds and tautness seen in certain patients with RRDs. The name was later changed to massive periretinal proliferation after Machemer and Laqua4 demonstrated ectopic cellular involvement in monkeys with retinal detachments. Later, in an effort to simplify the classification of different forms of the disease, the Retina society termed the disease PVR.5 Scientific investigators have spent over 25 years looking into the pathogenesis both at the gross anatomic level as well as the biochemical signaling cascade level that causes PVR., and although advancements have been made, a cure is still unknown. The purpose of this article is to provide clinicians at different levels of training an overview of PVR, epidemiology, and risk factors associated with the disease as well as to review different avenues of treatment currenth available in the literature.