Molecular Biologic Milieu in Rhegmatogenous Retinal Detachment and Proliferative Vitreoretinopathy: A Literature Review

Abstract

Multiple lines of evidence support an immunologic response along with inflammation to be implicated in the pathophysiology of primary rhegmatogenous retinal detachment (RRD) and the development of proliferative vitreoretinopathy (PVR). The purpose of this review is to provide an update on the signaling molecules into the vitreous and subretinal fluid (SRF) involved in these processes. A detailed literature search was performed in PubMed database until November 2021. We identified all papers referring to inflammatory and immunological mediators in the context of primary RRD and in cases complicated by PVR. We analyzed prospective and retrospective cohort studies and reference lists of the retrieved articles. A comprehensive investigation on immunological and inflammatory responses provides significant evidence for the implication of varying signaling molecules in the pathophysiology of RRD and the development of PVR. The reviewed series have revealed that disruption of the normal equilibrium during these processes may be present in the vitreous and SRF of these eyes. The precise role of cytokines, chemokines and growth factors in the pathophysiology of these disorders remains to be clearly elucidated. Overall, immunological and inflammatory signaling molecules are widely implicated in both primary RRD and PVR. The reviewed literature indicates that precise knowledge concerning the pathological milieu sheds light on the underlying pathophysiology and potential therapeutic targets, and highlights unmet needs to be addressed by future research.

Proliferative Vitreoretinopathy: Pathophysiology and Therapeutic Approaches

“…A list of selected molecular mediators is provided in Table 3, which is reproduced from a recent review on this topic. 10 These mediators include inflammatory cytokines, growth factors, immune cell chemokines, and molecules involved in wound healing. Given the extensive number of molecules that have been identified, the mechanisms underlying PVR are complex and likely involve dysregulation of numerous immunologic and There may also be a genetic predisposition for developing PVR.…”

“…Numerous molecular mediators have been implicated as possible contributors to the development of PVR, as they have been identified at higher concentrations in the intraocular fluids of patients with PVR. A list of selected molecular mediators is provided in Table 3, which is reproduced from a recent review on this topic 10 . These mediators include inflammatory cytokines, growth factors, immune cell chemokines, and molecules involved in wound healing.…”

4D label-free proteomic analysis of vitreous from patients with rhegmatogenous retinal detachment

“…The onset of RRD leads to macrophage activation and infiltration [22] . Pro-inflammatory and growth factors are released into the vitreous in patients with RRD [27] . Pro-inflammatory cytokines are significantly upregulated, promoting photoreceptor apoptosis in detached retina [28] .…”

Effect of silicone oil on retinal microcirculation after vitrectomy for rhegmatogenous retinal detachment evaluated by OCT angiography: a literature review

“…Indeed, an autoregulation phenomenon secondary to hypoxia may protect the retinal tissue against the damaging effect of irregular blood flow. 36,43,44 Retinal microvasculature blood flow changes…”