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Proliferative Vitreoretinopathie-Prozess – „To heal or not to heal“

Proliferative vitreoretinopathy process—To heal or not to heal

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Zusammenfassung

Hintergrund

Die proliferative Vitreoretinopathie (PVR) ist nach einem halben Jahrhundert Forschungstätigkeit weiterhin ein ungelöstes Problem.

Methoden

Es folgt ein Übersichtsbeitrag zu den Mechanismen der PVR im Kontext der „Wundheilungsforschung“.

Ergebnisse

Wundheilung ist ein physiologischer Reparaturmechanismus, der in allen Organen in ähnlicher Weise stattfindet und narbige Veränderungen hinterlassen kann. Die PVR basiert auf diesem Mechanismus. Die Besonderheit dieses Prozesses und seiner Folgen ergibt sich durch die Lokalisation und die beteiligten Strukturen. Die bisherigen medikamentösen Ansätze waren nicht ausreichend wirksam. Das wachsende Verständnis um die Mechanismen der narbenfreien fetalen Wundheilung könnte aber zur Lösung des PVR-Problems führen.

Schlussfolgerung

Die PVR ist ein physiologischer Prozess mit pathologischem Ergebnis. Die komplexen Schritte, die sukzessive ihren Beitrag zum Wundheilungsprozess leisten, sind gut verstanden. Eine Modifikation dieser Schritte, um den ursprünglichen Zustand wieder herzustellen, ist gegenwärtig weder in der Augenheilkunde noch in anderen medizinischen Fächern gelungen, aber möglich.

Abstract

Background

Proliferative vitreoretinopathy (PVR) is still an unsolved problem after half a century of research.

Methods

This article provides a review of mechanisms leading to PVR in the context of wound healing research.

Results

Wound healing is a physiological repair process that occurs in a similar way in all organs and may end in scar formation. The development of PVR is based on this wound healing mechanism. The localization and structures involved lead to specific characteristics and consequences. Up to now the pharmacotherapeutic strategies were not sufficiently effective. The growing understanding of the mechanisms of scar-free fetal wound healing, could however lead to a solution of the PVR problem.

Conclusion

The PVR is a physiological process with a pathological result. The complex steps involved in vitreoretinal wound healing are well understood. There is currently no therapeutic approach neither in ophthalmology nor in other medical disciplines that is able to restore the original function and structure of the involved tissue or organ but there is hope that this can succeed in the future.

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Authors and Affiliations

  1. Klinik für Augenheilkunde, Universitätsklinikum Schleswig-Holstein, Ratzeburger Allee 160, 23562, Lübeck, Deutschland

    S. Grisanti

  2. Klinik für Augenheilkunde, LMU München, München, Deutschland

    S. Priglinger

  3. Augenheilkunde, Klinikum Ludwigshafen, Ludwigshafen, Deutschland

    L. Hattenbach

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Grisanti, S., Priglinger, S. & Hattenbach, L. Proliferative Vitreoretinopathie-Prozess – „To heal or not to heal“. Ophthalmologe 118, 10–17 (2021). https://doi.org/10.1007/s00347-020-01294-0

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