Proliferative vitreoretinopathy (PVR) remains the most commonly observed failure in the surgery of rhegmatogenous retinal detachment (RRD), albeit substantial efforts have been taken to better understand and manage the condition in the past. Basic research indicates that proliferative vitreoretinopathy illustrates scarring – end-stage of wound healing process, which occurs post-retinal detachment surgery. Current medical treatment for PVR has been directed toward the prevention of inflammation – first stage of wound-healing process, and inhibition of cell proliferation – second stage.
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Surgery for proliferative vitreoretinopathy, at present, demonstrates high anatomical success rate, despite disappointing visual results. Utilization of adjunctive treatments for preventing cellular proliferation has been deemed effective in the treatment & prevention of PVR, or post-surgery recurrences. Proliferation control and strategies directed toward the improvement of visual outcome are imperative focus areas for future studies in PVR. In addition, researches on the peri-retinal and intra-retinal pathology of proliferative vitreoretinopathy have illustrated characteristic alterations, which will significantly influence surgical management and visual outcome.
A recent Fact.MR report foresees the proliferative vitreoretinopathy market to record a moderate rise over the period of forecast (2018-2027). Revenues from treatment and management of proliferative vitreoretinopathy worldwide will reach nearly US$ 660 Mn by 2027-end.
Proliferative Vitreoretinopathy Market: Potential of Systemic Anti-TNFα Treatment in Reduction of PVR to Influence Future Developments
Lack of effective prophylaxis or treatment has made proliferative vitreoretinopathy one of the most devastating complications witnessed in RRD. TNFα has been implied in PVR development, which in turn necessitates blockade of this factor for reducing or preventing onset of proliferative vitreoretinopathy. However, systemic treatment of PVR using anti-TNFα entails several side-effects and risks, and employment of such drugs for PVR treatment is not yet justified. Researchers have sought indirect approaches for determination of effectiveness of anti-TNFα in protection against PVR development post-RRD surgery.
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Despite sound principles on which the approaches are based, low prevalence of patients affected with RRD, chronic inflammatory diseases, and PVR has prevented researchers from drawing conclusions with regard to potential effectiveness of the anti-TNFα therapy as prophylactic treatment for preventing or reducing PVR incidences following RRD. However, these approaches hold promise in promoting future in-vivo studies, and randomizing clinical trials in humans with the help of more preclinical research.
Proliferative Vitreoretinopathy Market: New PVR Development Suppression & Prevention Methods to Underpin Growth
Proliferative vitreoretinopathy, an inflammatory fibrotic disease, stems from inflammatory milieu post-RRD, which in turn prevents retinal healing. Several studies aimed at suppressing or preventing the development of PVR are being conducted worldwide, with some of the recent ones elucidating effect of “substance P (SP),” and targeted use of non-steroidal anti-inflammatory drugs such as “lornoxicam.”
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Research carried out on lornoxicam has not only demonstrated successful improvement in the condition of retina and choroid, but also reduced frequency of membrane formation significantly. Studies conducted on substance P have revealed that SP has the capability of inhibiting apoptosis, and epithelial-mesenchymal transition (EMT) induced by TNFα caused, thereby suppressing or preventing development of proliferative retinopathy.