Proliferative Vitreoretinopathy

Pastor, J. Carlos

doi:10.1016/s0039-6257(98)00023-x

Cited by 359 publications

(279 citation statements)

References 100 publications

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“…9 The present study does not support this view; the specialist teams achieved markedly better anatomical results even in single-hole one or two quadrant cases. If confirmed elsewhere this has important consequences in relation to the planning of ophthalmic services, particularly in relation to macula-on detachments which are generally regarded as rather urgent.…”

Section: 'Simple' Detachmentscontrasting

confidence: 90%

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Triple cycle audit of primary retinal detachment surgery

Johnson

Ramsay

Cottrell

et al. 2002

Eye

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Purpose To determine the effect of increasing subspecialisation on the results of retinal detachment surgery in one city. Methods Three audit cycles over a 10-year period when major subspecialisation and organisational changes were occurring. Retrospective case note reviews of all primary surgery for rhegmatogenous retinal detachments in each of the audit periods. Statistical analyses used contingency table/chi-square methods for comparing all three audits and Fisher's exact test/mean odds ratio with 95% confidence intervals (CIs) for the Audit 1 vs Audit 3 comparison. Results A marked improvement in success rates occurred: primary reattachment rose from 67% in Audit 1 to 87% in Audit 3 (P = 0.0004), and final success from 84% to 97% (P = 0.0003). There was a dramatic change in operative techniques over the same period: the percentage of vitrectomies increased from 1.5% in Audit 1 to 48% in Audit 3, while that of 'open' conventional procedures decreased from 78% to 32%. However, the improvement in anatomical success was not mirrored by an increase in the percentage of patients with 6/12 or better visual acuity postoperatively (55% in Audit 1, 49% in Audit 3; P = 0.34, mean odds ratio = 0.78; 95% CI 0.48-1.2). The percentage of patients with 6/18-6/36 post op visual acuity did increase in Audit 3 (18% in Audit 1; 29% in Audit 3; P = 0.03, mean odds ratio = 1.9; CI 1.1-3.3), and the percentage with 6/60 or worse decreased (27% in Audit 1, 20% in Audit 3; P = 0.26, mean odds ratio = 0.71; CI 0.40-1.2). Conclusions With increased subspecialisation there has been an increase in anatomical success, but the goal of 100% reattachment is still not being attained. There remains scope for further improvement in anatomical and functional outcomes.

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Section: 'Simple' Detachmentscontrasting

confidence: 90%

“…8 However, PVR might arise from overvigorous cryotherapy. 9 There is clearly a balance to strike between under and over-treatment. In this context the marked reduction in the proportion of conventional operations, which were 'open', is interesting.…”

Section: Reasons For Failurementioning

confidence: 99%

Triple cycle audit of primary retinal detachment surgery

Johnson

Ramsay

Cottrell

et al. 2002

Eye

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“…As they use to grow into the vitreous body (and induce alterations there), this phenomenon is called proliferative vitreoretinopathy (PVR). 56 Proceeding PVR then leads to folding and detachment of the retina (Figure 3b), excessive neurodegeneration and blindness.…”

Section: Mü Ller Cells and Retinopathymentioning

confidence: 99%

Glia: the fulcrum of brain diseases

et al. 2007

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Neuroglia represented by astrocytes, oligodendrocytes and microglial cells provide for numerous vital functions. Glial cells shape the micro-architecture of the brain matter; they are involved in information transfer by virtue of numerous plasmalemmal receptors and channels; they receive synaptic inputs; they are able to release 'glio'transmitters and produce long-range information exchange; finally they act as pluripotent neural precursors and some of them can even act as stem cells, which provide for adult neurogenesis. Recent advances in gliology emphasised the role of glia in the progression and handling of the insults to the nervous system. The brain pathology, is, to a very great extent, a pathology of glia, which, when falling to function properly, determines the degree of neuronal death, the outcome and the scale of neurological deficit. Glial cells are central in providing for brain homeostasis. As a result glia appears as a brain warden, and as such it is intrinsically endowed with two opposite features: it protects the nervous tissue as long as it can, but it also can rapidly assume the guise of a natural killer, trying to eliminate and seal the damaged area, to save the whole at the expense of the part. The sudden emergence of an intellect, and therefore a human being, which materialised only around a million years ago, remains the main mystery for our self-understanding. Similarly, we still do not know by which steps or transitions the human intellect emerged from the animal kingdom and where the fundamental difference between a man and an animal lies. According to the neuronal doctrine, which governs modern neuroscience since the beginning of the twentieth century, 1,2 the neurone is regarded as a basic information processing unit consisting of dendrites and axons with a unidirectional flow of information from the receiving dendrites via the integrating cell body to the terminal branches of the axon. Neuronal networks, connected through synaptic contacts, are generally considered as the substrate of our intellect.The number and size of neural cells increase with the size of the body and of the brain of mammals. This increasing quantity eventually has caused the generation of a new quality, the intellect. Rather amazingly, however, there is a relatively little difference in the morphology and physiology of neurones between humans and beasts; similarly the density of synaptic contacts in the brains of rodents and humans is more or less constant at around 1100-1300 millions/mm 3 . 3 On the contrary, evolution of the nervous system resulted in great changes in the second type of neural cells, the neuroglia. 4 Indeed, phylogenetic advance in brain complexity and capabilities coincided with a remarkable increase in the number of glial cells: in the rodent cortex the glial to neurone ratio is about 0.3 : 1, whereas in humans the same ratio is several times higher being B1.65:1, 5 while the total number of glial cells in the human brain is B10 (or even more) times larger than in lesser mammals. Astrocytes ...

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“…[34][35][36] Adjunctive agents may specifically or non-specifically target: (a) the proliferating cell types known to be involved in PVR; (b) the production and subsequent contraction of the extracellular matrix; (c) the initial deposition of fibrin which may serve as the scaffold for subsequent membrane formation; and (d) the various growth factors which have been documented to mediate PVR development. 37 A number of agents have been analysed in experimental systems and in uncontrolled clinical trials (for a detailed discussion see Charteris 34 ).…”

Section: Adjunctive Treatmentmentioning

confidence: 99%