title: Clinical management of proliferative vitreoretinopathy: an update.
abstract: BACKGROUND
  Proliferative vitreoretinopathy (PVR) remains the most significant obstacle to successful retinal reattachment surgery. Preclinical studies continue to add insights into the complex molecular events leading to PVR development, helping to identify new targets for potential prophylactic or therapeutic agents. This article reviews the recent evidence supporting surgical and medical treatments for PVR.
  
  
  METHODS
  PUBMED was used for literature search. Clinical studies regarding surgical management of PVR from January 1, 2000 to August 1, 2014 were included. Clinical studies regarding medical management of PVR from January 1, 2000 to August 1, 2014 were included if the design of study was a randomized controlled trial.
  
  
  RESULTS
  Many recent studies have evaluated surgical and medical strategies for the treatment and prevention of PVR. Newer vitreoretinal surgery technology (23- and 25-gauge vitrectomy) and tamponade agents (heavy silicone oils) have been studied. Medical therapies evaluated include antiinflammatory agents, low molecular weight heparin, 5-fluorouracil, 13-cis-retinoic acid, and daunorubicin, amongst others.
  
  
  CONCLUSIONS
  Surgical management with pars plana vitrectomy, with or without scleral buckle or inferior retinectomy, remains an effective treatment for PVR-related detachments. Consensus regarding a preferred surgical strategy remains controversial. Many medical therapies have been studied but fail to demonstrate a statistically significant benefit in clinical trials. Further studies to clarify the efficacy of available and novel treatment options are warranted.
authors.affiliation: *Retina Service, Wills Eye Hospital, Philadelphia, Pennsylvania; †Mid Atlantic Retina, Wills Eye Hospital, Philadelphia, Pennsylvania; and ‡Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Mohammed A
authors.initials: MA
authors.lastname: Khan
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Brady
authors.forename: Richard S
authors.initials: RS
authors.lastname: Kaiser
mesh_terms: D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D058450:Endotamponade; D005472:Fluorouracil / Q000627:therapeutic use; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D015474:Isotretinoin / Q000627:therapeutic use; D012591:Scleral Buckling; D014821:Vitrectomy; D018630:Vitreoretinopathy, Proliferative / Q000188:drug therapy* / Q000601:surgery*
chemical_list: D000893:Anti-Inflammatory Agents; D006495:Heparin, Low-Molecular-Weight; D007166:Immunosuppressive Agents; D015474:Isotretinoin; D005472:Fluorouracil