Authors
Federico Giannuzzi, Antonio Pio Manzo, Mattia Cusato, Lorenzo Hu, Giuseppe Liuzzi, Valentina Cestrone, Umberto De Vico, Stanislao Rizzo
Published in
Survey of ophthalmology. Oct 13, 2026. Epub Oct 13, 2026.
Abstract
Proliferative vitreoretinopathy (PVR) represents the most significant complication and the primary cause of surgical failure in regmatogenous retinal detachment repair, occurring in approximately 5-10% of cases. The pathophysiology of PVR involves a counterproductive wound-healing response where retinal pigment epithelium and glial cells undergo dedifferentiation, migration, and proliferation. This process is largely driven by epithelial-to-mesenchymal transition (EMT) and a complex milieu of inflammatory mediators and growth factors, most notably platelet-derived growth factor and transforming growth factor beta. We investigate the evolving role of adjuvant pharmacotherapy in preventing and treating PVR. Traditional anti-inflammatory agents and anti-vascular endothelial gowth facrtor therapies have failed to demonstrate significant improvements in anatomical reattachment rates in human clinical trials. Conversely, anti-proliferative agents have shown more clinical potential; specifically, methotrexate has emerged as a leading candidate. Other promising strategies include the use of combined 5-fluorouracil and low molecular weight heparin, daunorubicin, and emerging biological therapies such as Rho Kinase and m-TOR inhibitors. Furthermore, innovative bio-functional polymers are being developed to modulate RNA transcription and suppress EMT factors. Therefore, PVR management is shifting toward a multimodal paradigm that integrates advanced surgical techniques with targeted molecular inhibition to improve functional success.
PMID:
42869267
Bibliographic data and abstract were imported from PubMed on 14 Oct 2026.
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