An Overview of Potential Applications of Heparin in Vitreoretinal Surgery

Blumenkranz, Mark S.; Hartzer, Michael K.; Iverson, Deborah A.

doi:10.1097/00006982-199212031-00015

Cited by 31 publications

(13 citation statements)

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“…Heparin is a naturally occurring complex polysaccharide that is able to bind fibronectin and a range of growth factors involved in the pathogenesis of PVR, such as FGF and PDGF [108]. …”

Section: Pathobiology and Pathophysiology Of Pvrmentioning

confidence: 99%

Proliferative Vitreoretinopathy after Eye Injuries: An Overexpression of Growth Factors and Cytokines Leading to a Retinal Keloid

Morescalchi

Duse

Gambicorti

et al. 2013

Mediators of Inflammation

125

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Eye injury is a significant disabling worldwide health problem. Proliferative Vitreoretinopathy (PVR) is a common complication that develops in up to 40–60% of patients with an open-globe injury. Our knowledge about the pathogenesis of PVR has improved in the last decades. It seems that the introduction of immune cells into the vitreous, like in penetrating ocular trauma, triggers the production of growth factors and cytokines that come in contact with intra-retinal cells, like Müller cells and RPE cells. Growth factors and cytokines drive the cellular responses leading to PVR's development. Knowledge of the pathobiological and pathophysiological mechanisms involved in posttraumatic PVR is increasing the possibilities of management, and it is hoped that in the future our treatment strategies will evolve, in particular adopting a multidrug approach, and become even more effective in vision recovery. This paper reviews the current literature and clinical trial data on the pathogenesis of PVR and its correlation with ocular trauma and describes the biochemical/molecular events that will be fundamental for the development of novel treatment strategies. This literature review included PubMed articles published from 1979 through 2013. Only studies written in English were included.

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“…Heparin is a naturally occurring complex polysaccharide that is able to bind fibronectin and a range of growth factors involved in the pathogenesis of PVR, such as FGF and PDGF [108]. …”

Section: Pathobiology and Pathophysiology Of Pvrmentioning

confidence: 99%

Proliferative Vitreoretinopathy after Eye Injuries: An Overexpression of Growth Factors and Cytokines Leading to a Retinal Keloid

Morescalchi

Duse

Gambicorti

et al. 2013

Mediators of Inflammation

125

View full text Add to dashboard Cite

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“…Low-molecular-weight heparin (LMWH) is an anticoagulant that binds fibronectin, bFGF, PDGF, and other growth factors [65]. Animal studies have found some efficacy of 5-FU for the treatment of vitreoretinal scarring [66, 67], but results in human clinical trials have been mixed (Table 2) [68–70].…”

Section: 5-fluorouracil (5-fu) and Low-molecular-weight Heparin (mentioning

confidence: 99%

Mechanisms of Inflammation in Proliferative Vitreoretinopathy: From Bench to Bedside

Moysidis

Thanos

Vavvas

2012

Mediators of Inflammation

104

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Proliferative vitreoretinopathy (PVR) is a vision-threatening disease and a common complication of surgery to correct rhegmatogenous retinal detachment (RRD). Several models of the pathogenesis of this disease have been described with some of these models focusing on the role of inflammatory cells and other models focusing on the role of growth factors and cytokines in the vitreous which come into contact with intraretinal and retinal pigment epithelial cells. New experiments have shed light on the pathogenesis of PVR and offer promising avenues for clinical intervention before PVR develops. One such target is the indirect pathway of activation of platelet-derived growth factor receptor alpha (PDGRα), which plays an important role in PVR. Clinical trials assessing the efficacy of 5-fluorouracil (5-FU) and low-molecular-weight heparin (LMWH), daunorubicin, and 13-cis-retinoic acid, among other therapies, have yielded mixed results. Here we review inflammatory and other mechanisms involved in the pathogenesis of PVR, we highlight important clinical trials, and we discuss how findings at the bench have the potential to be translated to the bedside.

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“…Following randomized applications in vitreoretinal surgery [75] LMWHs have been used alone [76] or in combination with 5-fluoro-uracil [77], to mitigate the high risk of post-operative vitreoretinopathies, with significant improvement. As recently reviewed [78] in other clinical trials there was no statistical difference in the primary outcome, showing a narrow spectrum of experimental activity compared to heparin.…”

Section: Other Investigated Activities Of Lmwhsmentioning

confidence: 99%