Proliferative Vitreoretinopathy Mechanisms and Treatment Strategies

Proliferative vitreoretinopathy (PVR) is a vision-threatening sequela of rhegmatogenous retinal detachment and ocular trauma, characterised by the aberrant proliferation, migration and contraction of retinal cells that culminate in fibrotic membrane formation and tractional retinal detachment. Central to its pathogenesis is the activation of retinal pigment epithelial (RPE) cells and glia, which undergo epithelial–mesenchymal transition (EMT) under the influence of growth factors and cytokines such as transforming growth factor-β (TGF-β), platelet-derived growth factor (PDGF) and interleukins. Downstream signalling cascades—including NFκB and PI3K/Akt—further amplify fibrogenic responses. While surgical vitrectomy remains the mainstay of management, adjunct pharmacotherapies have produced mixed results. Emerging approaches seek to modulate EMT, inhibit key molecular drivers and deliver antiproliferative or anti-inflammatory agents via targeted gene therapy and nanocarrier systems. Concurrent biomarker discovery offers the prospect of earlier diagnosis, risk stratification and personalised intervention.

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Proliferative Vitreoretinopathy Mechanisms and Treatment Strategies publication trend

The graph below shows the total number of articles in proliferative vitreoretinopathy mechanisms and treatment strategies across all publications each year (not limited to Nature Index journals).

Technical terms

Proliferative vitreoretinopathy (PVR): A fibrotic complication of retinal detachment characterised by membrane formation and retinal traction.

Epithelial–mesenchymal transition (EMT): Process by which epithelial cells acquire mesenchymal phenotype, increasing motility and matrix production.

Retinal pigment epithelium (RPE): Monolayer of pigmented cells supporting photoreceptor health, central to PVR membrane formation.

Adeno-associated virus (AAV): Non-pathogenic viral vector used for gene delivery to retinal cells.

Exosome: Nanometre-scale extracellular vesicle mediating intercellular transport of proteins and nucleic acids.

Cytokine: Signalling protein secreted by immune or resident cells that regulates inflammation and cellular responses.

References

1. DAPL1 prevents epithelial–mesenchymal transition in the retinal pigment epithelium and experimental proliferative vitreoretinopathy. Cell Death & Disease (2023).
2. Exosomes-based dual drug-loaded nanocarrier for targeted and multiple proliferative vitreoretinopathy therapy. Regenerative Biomaterials (2024).
3. Vitreous Olink proteomics reveals inflammatory biomarkers for diagnosis and prognosis of traumatic proliferative vitreoretinopathy. Frontiers in Immunology (2024).
4. NFκB-Mediated Expression of Phosphoinositide 3-Kinase δ Is Critical for Mesenchymal Transition in Retinal Pigment Epithelial Cells. Cells (2023).