增生性玻璃体视网膜病变发病机制与治疗的研究进展

Research Progress of Pathogenesis and Treatment of Proliferative Vitreoretinopathy

增生性玻璃体视网膜病变(PVR)是一种纤维化改变的过程,也是视网膜复位手术后复发的主要因素,复杂的发病机制及病理变化参与这一过程。一系列因素刺激视网膜色素上皮细胞由上皮表型向间质表型转变,通过上皮-间充质转化(EMT)过程从而引起玻璃体视网膜纤维化改变。目前PVR的主流治疗方法仍为外科手术,通过术前危险因素的控制,及根据病变发展的不同时期采用适当的手术,同时辅助药物治疗通常可以改善疾病预后。已有证据证实,维生素D能够通过抑制上皮细胞EMT来减轻转化生长因子β诱导的促纤维化作用。其所具有的抗纤维化作用已越来越多地被用于临床疾病的研究与治疗,然而维生素D在眼疾病中的研究仍很局限,值得进一步开发。

Proliferative vitreoretinopathy(PVR)is not only a process of fibrosis,but also a major cause of recurrence after retinal reattachment surgery,involving complicated pathogenesis and pathological changes.A series of factors,stimulate the transformation of retinal pigment epithelium cells from epithelial phenotype to mesenchymal phenotype,which results in the changes in vitreous retinal fibrosis,through the epithelial-mesenchymal transition(EMT)process.The mainstream treatment of PVR is still surgery,and some measures should be taken,such as the risk control before operation,the appropriate operation based on the different stages of disease development and the adjuvant drug therapy to improve the prognosis of the disease.It has been proved that vitamin D is able to alleviate the transforming growth factorβinduced fibrotic effect through inhibiting the epithelial cell EMT.Its anti-fibrosis effect has been widely applied in the study and treatment of clinical diseases.However,the study of vitamin D in eye diseases is still limited and worthy of further development.