The pathogenesis of pterygia

Coroneo, Minas T.; Girolamo, Nick Di; Wakefield, Denis

doi:10.1097/00055735-199908000-00011

Cited by 226 publications

(190 citation statements)

References 40 publications

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“…20 Recurrence is the single most important complication following surgical excision of the pterygium. The recurrence risk rises with increasing number of excisions.…”

Section: Discussionmentioning

confidence: 99%

Intra-lesional 5 fluorouracil for the management of recurrent pterygium

Said

Faraj

El‐Alfy

et al. 2013

Eye

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Aim Recurrence is the most common complication arising from pterygium surgery. The aim of this study was to investigate the effectiveness of 5 fluorouracil (5FU) in halting the recurrence of pterygium after surgical excision. Methods A retrospective review of patients treated for pterygium recurrence was carried out. Patients with recurrent (secondary) pterygium were treated with multiple weekly intra-lesional injections of 0.1-0.2 ml (2.5-5 mg) 5FU post-operatively depending on the size of the recurrence. The treatment was started within 1 month from the date of recurrence. The time from surgery to start of recurrence, previous treatment modalities, and number of recurrences were documented. The number of injections required to induce arrest of progression and/ or regression of vascularity and fleshiness of the pterygium and any complications related to 5FU treatment were examined. Results Fifteen eyes from 14 patients with recurrent pterygium treated with intralesional 5FU injections were analysed. Three of the 15 eyes had undergone a secondary excision and 12 had undergone a primary excision. In all, 93.3% of patients showed regression of the fibrovascular tissue (thickness and vascularity) and arrest of progression following a dose of 0.1-0.2 ml (2.5-5 mg) 5FU. Twelve eyes required three injections or fewer, whereas one patient required eight injections. This beneficial effect was maintained over an average follow-up period of 17 months. No complications from 5FU were observed. Conclusion The use of weekly intra-lesional 5FU injections for the treatment of recurrent pterygium is safe and effective in limiting the progression and inducing the regression of recurrent pterygium. The number of injections can be tailored according to clinical need.

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“…20 Recurrence is the single most important complication following surgical excision of the pterygium. The recurrence risk rises with increasing number of excisions.…”

Section: Discussionmentioning

confidence: 99%

Intra-lesional 5 fluorouracil for the management of recurrent pterygium

Said

Faraj

El‐Alfy

et al. 2013

Eye

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“…Pterygium is a common ophthalmic disease of unknown cause and pathogenesis, 1 and it was called as an ophthalmic enigma. 2 However, many regard it to be a consequence of ultraviolet-induced damage with subsequent elastoid degeneration of the subepithelial connective tissue, [3][4][5] and it is strongly related to ocular sun exposure.…”

Section: Introductionmentioning

confidence: 99%

Pterygium in an aged Mongolian population: a population-based study in China

Lü

Wang

Lü

et al. 2007

Eye

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Aims To determine the prevalence and identify associated risk factors for pterygium in an elderly Mongolian population at high altitude in Henan County, China. Methods A population-based survey was conducted from June 2006 to September 2006. A stratified, clustered, random sampling procedure was used to select 2486 Mongolian people aged 40 years and older. Pterygium was diagnosed and graded clinically as grade 1 (transparent), 2 (intermediate), and 3 (opaque). Risk factors associated with pterygium were evaluated with logistic regression models. Results From 2486 eligible subjects, 2112 (84.9%) were examined. There were 378 people with either unilateral (n ¼ 228) or bilateral (n ¼ 150) pterygia, equivalent to an overall prevalence of 17.9% (95% confidence interval (CI) 16.3, 19.5). The prevalence increased with older age (v 2 -test of trend Po0.001). Visual acuity decreased with higher group of pterygium (v 2 ¼ 97.759, Po0.0001). Pterygium was independently associated with Schirmer's test (p5 mm) (odds ratio (OR) 2.4; 95% CI, 1.9, 3.1), tear breakup time (p10 s) (OR 2.3; 95% CI, 1.8, 2.9), lower education level (o3 years) (OR 2.1; 95% CI, 1.4, 3.2), increasing age (OR 2.0; 95% CI, 1.4, 2.8) for persons 70-79, compared with 40-49, and other risk factors. Conclusions The prevalence of pterygium in an older Mongolian population at high altitude is high, primarily because of ocular sun exposure and the other effects of the unique plateau climate, and representing an important health problem. People should be strongly encouraged to wear a wide-brimmed hat and/or sunglasses whenever they are outside.

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“…1 Many suffer from this aggressive disease and its prevalence in the general population has been estimated to be 7-13%. 2,3 Several environmental factors that may induce ocular inflammation and various cytokines have been reported to be involved in the development of pterygium.…”

Section: Introductionmentioning

confidence: 99%

Endothelial progenitor cells in pterygium pathogenesis

Lee

Song

et al. 2006

Eye

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Purpose The pathogenesis of pterygium is not well known, and controversy exists about the cell origins and the nature of initial trigger required for its development. We investigated whether endothelial progenitor cells (EPCs) are involved in pathogenesis of pterygium and the mechanism underlying the selective recruitment of EPCs during this process. Methods We studied 13 normal controls and 28 pterygium patients (primary (n ¼ 15), recurrent (n ¼ 13)). Substance-P, vascular endothelial growth factor (VEGF), and stem cell factor (SCF) were measured in plasma and tears using ELISA, and circulating CD34 þ and c-kit þ mononuclear cells (MNCs) by flow cytometry. Anterior segment fluorescein angiography (FAG) was performed to evaluate hypoxic conditions in the early stage of pterygium. Surgically removed pterygial tissues were analyzed immunohistochemically using the progenitor cell markers, CD34, c-kit, VEGFR-1, and VEGFR-2. Results Anterior segment FAG findings showed an increase in non-perfusion areas and attenuated vessels in the nasal limbus during early-stage pterygium. Circulating CD34 þ MNCs and c-kit þ MNCs were increased in pterygium groups compared with normal controls. Systemic and local cytokines including SP, VEGF, and SCF in pterygium groups were also elevated and showed positive correlations with CD34 þ and c-kit þ MNC numbers. Immunohistochemical analysis of pterygium showed strong progenitor cell marker immunoreactivities. Conclusions EPCs might be involved in pterygium development, and ocular hypoxia triggers this neovascularization by recruiting EPCs derived from the bone marrow via the production of systemic and local cytokines.

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The pathogenesis of pterygia

Cited by 226 publications

References 40 publications

Intra-lesional 5 fluorouracil for the management of recurrent pterygium

Intra-lesional 5 fluorouracil for the management of recurrent pterygium

Pterygium in an aged Mongolian population: a population-based study in China

Endothelial progenitor cells in pterygium pathogenesis

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