Pharmacotherapy of proliferative vitreoretinopathy

Abstract

Proliferative vitreoretinopathy (PVR) is the most common cause of late anatomic failure in retinal detachment surgery, with a reported incidence of 5–11 % of all rhegmatogenous retinal detachments [1]. PVR can be considered an exaggerated wound healing response in specialized tissue, resulting in the formation of complex fibrocellular membranes on both surfaces of the retina and the posterior vitreous cortex. Contraction of these membranes then distorts the normal retinal architecture with resultant visually detrimental sequelae and/or traction retinal detachment, with re-opening of preexisting retinal breaks or the formation of new ones. Based on the premise that the primary pathology was centered in the vitreous, PVR was previously referred to as massive vitreous retraction syndrome (MVR) or massive preretinal retraction syndrome (MPR). However, to acknowledge the role of periretinal membrane formation and pigment epithelial cell proliferation, PVR later became known as massive periretinal proliferation (MPP) [2]. A unifying classification system was established in 1983 by the Retina Society Terminology Committee [1] coining the phrase proliferative vitreoretinopathy (PVR), which was later updated in 1991 to the current classification system in clinical practice today [3].