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Principles in the Management of Proliferative Vitreoretinopathy

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Cutting-edge Vitreoretinal Surgery

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Abstract

Proliferative vitreoretinopathy is the most common cause of failed repair of rhegmatogenous retinal detachment. Advances in technique and instrumentation of vitrectomy have led to improved surgical outcomes. The vitreoretinal surgery for PVR is aimed at providing permanent support to the retina from any ongoing traction and to close any open retinal breaks. These can be successfully achieved by an encircling scleral buckle, meticulous relief of all retinal traction with vitrectomy, and temporary or long-term tamponade of the retina with long-acting agents.

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References

  1. Wickham L, Ho-Yen GO, Bunce C, Wong D, Charteris DG. Surgical failure following primary retinal detachment surgery by vitrectomy: risk factors and functional outcomes. Br J Ophthalmol. 2011;95:1234–8.

    Article  PubMed  Google Scholar 

  2. Casaroli Marano RP, Vilaro S. The role of fibronectin, laminin, vitronectin and their receptors on cellular adhesion in proliferative vitreoretinopathy. Invest Ophthalmol Vis Sci. 1994;35:2791–803.

    CAS  PubMed  Google Scholar 

  3. Moysidis SN, Thanos A, Vavvas DG. Mechanisms of inflammation in proliferative vitreoretinopathy: from bench to bedside. Mediat Inflamm. 2012;2012:815937.

    Article  Google Scholar 

  4. Nagasaki H, Shinagawa K, Mochizuki M. Risk factors for proliferative vitreoretinopathy. Prog Retin Eye Res. 1998;17:77–98.

    Article  CAS  PubMed  Google Scholar 

  5. Charteris DG, Sethi CS, Lewis GP, Fisher SK. Proliferative vitreoretinopathy – developments in adjunctive treatment and retinal pathology. Eye. 2002;16:369–74.

    Article  CAS  PubMed  Google Scholar 

  6. Bonnet M, Guenoun S. Surgical risk factors for severe postoperative proliferative vitreoretinopathy (PVR) in retinal detachment with grade B PVR. Graefes Arch Clin Exp Ophthalmol. 1995;233:789–91.

    Article  CAS  PubMed  Google Scholar 

  7. Jaccoma EH, Conway BP, Campochiaro PA. Cryotherapy causes extensive breakdown of the blood-retinal barrier. A comparison with argon laser photocoagulation. Arch Ophthalmol. 1985;103:1728–30.

    Article  CAS  PubMed  Google Scholar 

  8. Xu K, Chin EK, Bennett SR, et al. Predictive factors for proliferative vitreoretinopathy formation after uncomplicated primary retinal detachment repair. Retina. 2019;39(8):1488–95.

    Article  CAS  PubMed  Google Scholar 

  9. Garweg JG, Tappeiner C, Halberstadt M. Pathophysiology of proliferative vitreoretinopathy in retinal detachment. Surv Ophthalmol. 2013;58:321–9.

    Article  PubMed  Google Scholar 

  10. Khan MA, Brady CJ, Kaiser RS. Clinical management of proliferative vitreoretinopathy: an update. Retina. 2015;35(2):165–75.

    Article  PubMed  Google Scholar 

  11. Jin Y, Chen H, Xu X, Hu Y, Wang C, Ma Z. Traumatic proliferative vitreoretinopathy: clinical and histopathological observations. Retina. 2017;37(7):1236–45.

    Article  PubMed  Google Scholar 

  12. Lai FH, Lo EC, Chan VC, Brelen M, Lo WL, Young AL. Combined pars plana vitrectomy-scleral buckle versus pars plana vitrectomy for proliferative vitreoretinopathy. Int Ophthalmol. 2016;36(2):217–24.

    Article  PubMed  Google Scholar 

  13. Storey P, Alshareef R, Khuthaila M, et al. Pars plana vitrectomy and scleral buckle versus pars plana vitrectomy alone for patients with rhegmatogenous retinal detachment at high risk for proliferative vitreoretinopathy. Retina. 2014;34(10):1945–51.

    Article  PubMed  Google Scholar 

  14. Adelman RA, Parnes AJ, Sipperley JO, Ducournau D, European Vitreo-Retinal Society (EVRS) Retinal Detachment Study Group. Strategy for the management of complex retinal detachments: the European vitreo-retinal society retinal detachment study report 2. Ophthalmology. 2013;120(9):1809–13.

    Article  PubMed  Google Scholar 

  15. Totsuka K, Inui H, Roggia MF, Hirasawa K, Noda Y, Ueta T. Supplemental scleral buckle in vitrectomy for the repair of rhegmatogenous retinal detachment: a systematic review of literature and meta-analysis. Retina. 2015;35(11):2423–31.

    Article  PubMed  Google Scholar 

  16. Kim HC, Hayashi A, Shalash A, de E Jr. A model of chronic hypotony in the rabbit. Graefes Arch Clin Exp Ophthalmol. 1998;236:69–74.

    Article  CAS  PubMed  Google Scholar 

  17. Aaberg TM. Management of anterior and posterior proliferative vitreoretinopathy. XLV. Edward Jackson memorial lecture. Am J Ophthalmol. 1988;106:519–32.

    Article  CAS  PubMed  Google Scholar 

  18. Garnier S, Rahmi A, Grasswil C, Kodjikian L. Three hundred and sixty degree retinotomy for retinal detachments with severe proliferative vitreoretinopathy. Graefes Arch Clin Exp Ophthalmol. 2013;251(9):2081–5.

    Article  PubMed  Google Scholar 

  19. Lim AK, Alexander SM, Lim KS. Combined large radial retinotomy and circumferential retinectomy in the management of advanced proliferative vitreoretinopathy. Retina. 2009;29(1):112–6.

    Article  PubMed  Google Scholar 

  20. Nagpal M, Jain P, Nagpal K. Outcomes of retinectomy of 180° or more in retinal detachment with advanced proliferative vitreoretinopathy. World J Retina Vitr. 2011;1(2):63–8.

    Article  Google Scholar 

  21. Alturki WA, Peyman GA, Paris CL, Blinder KJ, Desai UR, Nelson NC Jr. Posterior relaxing retinotomies: analysis of anatomic and visual results. Ophthalmic Surg. 1992;23:685–8.

    CAS  PubMed  Google Scholar 

  22. Federman JL, Eagle RC Jr. Extensive peripheral retinectomy combined with posterior 360 degrees retinotomy for retinal reattachment in advanced proliferative vitreoretinopathy cases. Ophthalmology. 1990;97:1305–20.

    Article  CAS  PubMed  Google Scholar 

  23. Wallyn RH, Hilton GF. Subretinal fbrosis in retinal detachment. Arch Ophthalmol. 1979;97:2128–9.

    Article  CAS  PubMed  Google Scholar 

  24. Machemer R. Surgical approaches to subretinal strands. Am J Ophthalmol. 1980;90:81–5.

    Article  CAS  PubMed  Google Scholar 

  25. Lewis H, Aaberg TM, Abrams GW, et al. Subretinal membranes in proliferative vitreoretinopathy. Ophthalmology. 1989;96:1403–14, discussion 1414–15.

    Article  CAS  PubMed  Google Scholar 

  26. Tabandeh H. A surgical technique for the management of retinal detachment associated with severe proliferative vitreoretinopathy. Retina. 2017;37(7):1407–10.

    Article  PubMed  Google Scholar 

  27. Rizzo S, Genovesi-Ebert F, Vento A, et al. A new heavy silicone oil (HWS 46-3000) used as a prolonged internal tamponade agent in complicated vitreoretinal surgery: a pilot study. Retina. 2007;27:613–20.

    Article  PubMed  Google Scholar 

  28. Joussen AM, Rizzo S, Kirchhof B, et al. Heavy silicone oil versus standard silicone oil in as vitreous tamponade in inferior PVR (HSO study): interim analysis. Acta Ophthalmol. 2011;89:483–9.

    Article  Google Scholar 

  29. Sigler EJ, Randolph JC, Calzada JI, Charles S. Pars plana vitrectomy with medium-term postoperative perfluoro-N-octane for recurrent inferior retinal detachment complicated by advanced proliferative vitreoretinopathy. Retina. 2013;33(4):791–7.

    Article  CAS  PubMed  Google Scholar 

  30. Rizzo S, Barca F, Faraldi F, Caporossi T, Virgili G. Staining-assisted removal of silicone oil for the identification of subclinical proliferative vitreoretinopathy. Retina. 2017;37(11):2118–23.

    Article  PubMed  Google Scholar 

  31. Nagpal MP, Videkar RP, Nagpal KM. Factors having implications on re-retinal detachments after silicone oil removal. Indian J Ophthalmol. 2012;60(6):517–20.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Nagpal M, Bhatt KJ, Jain P, Taleb EA, Goswami S, Verma A. Correlation of spectral domain optical coherence tomography findings in sub-silicone oil foveal depression space and visual outcome in eyes undergoing silicone oil removal. Taiwan J Ophthalmol. 2016;6(1):21–5.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Constable I, Nagpal M. 111. Proliferative vitreoretinopathy. In: Retina. 6th ed. Cleveland: Elsevier; 2018. p. 2031–51.

    Google Scholar 

  34. Ricker LJ, Dieudonne SC, Kessels AG, et al. Antiangiogenic isoforms of vascular endothelial growth factor predominate in subretinal fluid of patients with rhegmatogenous retinal detachment and proliferative vitreoretinopathy. Retina. 2012;32:54–9.

    Article  CAS  PubMed  Google Scholar 

  35. Armstrong D, Augustin AJ, Spengler R, et al. Detection of vascular endothelial growth factor and tumor necrosis factor alpha in epiretinal membranes of proliferative diabetic retinopathy, proliferative vitreoretinopathy and macular pucker. Ophthalmologica. 1998;212:410–4.

    Article  CAS  PubMed  Google Scholar 

  36. Zhao XY, Xia S, Wang EQ, Chen YX. Efficacy of intravitreal injection of Bevacizumab in vitrectomy for patients with proliferative vitreoretinopathy retinal detachment: a meta-analysis of prospective studies. Retina. 2018;38(3):462–70.

    Article  CAS  PubMed  Google Scholar 

  37. Hsu J, Khan MA, Shieh WS, et al. Effect of serial intrasilicone oil bevacizumab injections in eyes with recurrent proliferative vitreoretinopathy retinal detachment. Am J Ophthalmol. 2016;161:65–70.

    Article  CAS  PubMed  Google Scholar 

  38. Furino C, Micelli Ferrari T, Boscia F, Cardascia N, Recchimurzo N, Sborgia C. Triamcinolone-assisted pars plana vitrectomy for proliferative vitreoretinopathy. Retina. 2003;23(6):771–6.

    Article  PubMed  Google Scholar 

  39. Shi H, Guo T, Liu PC, Wang QY, Du YR, Liu QY, He MM, Liu JL, Yu J. Steroids as an adjunct for reducing the incidence of proliferative vitreoretinopathy after rhegmatogenous retinal detachment surgery: a systematic review and meta-analysis. Drug Des Dev Ther. 2015;9:1393–400.

    CAS  Google Scholar 

  40. Banerjee PJ, Quartilho A, Bunce C, Xing W, Zvobgo TM, Harris N, Charteris DG. Slow-release dexamethasone in proliferative vitreoretinopathy: a prospective, randomized controlled clinical trial. Ophthalmology. 2017;124(6):757–67.

    Article  PubMed  Google Scholar 

  41. Kumar A, Nainiwal S, Sreenivas B. Intravitreal low molecular weight heparin in PVR surgery. Indian J Ophthalmol. 2003;51:67–70.

    PubMed  Google Scholar 

  42. Sadaka A, Giuliari GP. Proliferative vitreoretinopathy: current and emerging treatments. Clin Ophthalmol. 2012;6:1325–33.

    PubMed  PubMed Central  Google Scholar 

  43. Pennock S, Haddock LJ, Eliott D, Mukai S, Kazlauskas A. Is neutralizing vitreal growth factors a viable strategy to prevent proliferative vitreoretinopathy? Prog Retin Eye Res. 2014;40:16–34.

    Article  CAS  PubMed  Google Scholar 

  44. Falavarjani KG, Hashemi M, Modarres M, Khani AH. Intrasilicone oil injection of bevacizumab at the end of retinal reattachment surgery for severe proliferative vitreoretinopathy. Eye. 2014;28(5):576–80. https://doi.org/10.1038/eye.2014.21.

    Article  CAS  Google Scholar 

  45. Ito S, Sakamoto T, Tahara Y, et al. The effect of tranilast on experimental proliferative vitreoretinopathy. Graefes Arch Clin Exp Ophthalmol. 1999;237(8):691–6.

    Article  CAS  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Retina and Vitreous, Retina Foundation, Ahmedabad, Gujarat, India

    Manish Nagpal, Shachi Wachasundar, Gayathri Mohan & Ahmed Eltayib

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  1. Manish Nagpal
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  2. Shachi Wachasundar
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  3. Gayathri Mohan
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  4. Ahmed Eltayib
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Editor information

Editors and Affiliations

  1. Aditya Jyot Foundation for Twinkling Little Eyes, Aditya Jyot Eye Hospital, Mumbai, India

    Astha Jain

  2. Aditya Jyot Foundation for Twinkling Little Eyes, Aditya Jyot Eye Hospital, Mumbai, India

    S. Natarajan

  3. Department of Ophthalmology, King George’s Medical University, Lucknow, Uttar Pradesh, India

    Sandeep Saxena

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Nagpal, M., Wachasundar, S., Mohan, G., Eltayib, A. (2021). Principles in the Management of Proliferative Vitreoretinopathy. In: Jain, A., Natarajan, S., Saxena, S. (eds) Cutting-edge Vitreoretinal Surgery. Springer, Singapore. https://doi.org/10.1007/978-981-33-4168-5_15

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  • DOI: https://doi.org/10.1007/978-981-33-4168-5_15

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  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-33-4167-8

  • Online ISBN: 978-981-33-4168-5

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