Proliferative vitreoretinopathy (PVR) remains a major barrier in vitreoretinal surgery, being the leading cause of recurrent retinal detachment and surgical failure. PVR arises from abnormal wound healing, involving epithelial-mesenchymal transition (EMT) of retinal pigment epithelial cells, hyalocytes trans-differentiation into myofibroblasts, and dysregulated interactions among cytokines, growth factors, and chemokines. These lead to extracellular matrix remodeling and contractile membrane formation. Recent advancements have deepened insight into disease mechanisms and supported preclinical testing of therapies. Despite surgical progress, adjunctive treatments such as corticosteroids, antimetabolites, retinoids, and biologics show limited and inconsistent benefits in clinical trials. Emerging tools like proteomic biomarkers and advanced imaging offer promise for early risk detection and personalized care. However, major challenges remain in understanding disease complexity and improving tailored treatment outcomes. This review emphasizes the urgent need for targeted molecular therapies. Bridging basic science with clinical innovation will be key to advancing PVR management and preserving vision.
Zheng et al. (Sun,) studied this question.