# Drug strategies for the treatment and prevention of proliferative vitreoretinopathy: an overview of innovative treatment concepts

## TL;DR

This paper reviews new drug strategies for preventing and treating proliferative vitreoretinopathy, focusing on agents that target inflammation and cell growth.

## Contribution

The paper provides a comprehensive overview of emerging pharmacological agents and their mechanisms for treating proliferative vitreoretinopathy.

## Key findings

- Methotrexate and infliximab show promise as anti-proliferative and anti-inflammatory agents in PVR.
- Preclinical data support pharmacological modulation of PVR, but clinical translation remains limited.
- Risk stratification based on preoperative factors may improve patient selection for future trials.

## Abstract

To present an overview of emerging pharmacological strategies for the prevention and treatment of proliferative vitreoretinopathy (PVR).

This review critically examines recent experimental and clinical evidence on pharmacological agents targeting key pathogenic mechanisms of PVR, including epithelial–mesenchymal transition, profibrotic cytokine signaling (TGF-β, PDGF, VEGF), and inflammation-driven tissue remodeling. Investigated compounds include clinically tested substances such as daunorubicin, 5-fluorouracil, corticosteroids, anti-VEGF agents, methotrexate, isotretinoin, decorin and infliximab, as well as newer experimental approaches including Topotecan, Melphalan, ROCK-Inhibitors and gene-regulated therapies. Mechanistic insights into receptor crosstalk, intracellular signaling cascades, and cell survival pathways are integrated with findings from preclinical models and clinical studies.

Several agents have shown anti-proliferative and anti-inflammatory effects in vitro and in vivo, with methotrexate and infliximab emerging as particularly promising candidates. However, clinical data remain heterogeneous, and no pharmacological agent has yet received regulatory approval for PVR treatment. Risk stratification based on preoperative PVR, vitreous hemorrhage, or ocular trauma may help optimize patient selection in future trials.

Pharmacological modulation of PVR is conceptually well supported by preclinical data, but clinical translation remains limited. Well-designed randomized trials in clearly defined high-risk populations are needed to validate efficacy, determine optimal treatment windows, and develop standardized protocols for both prophylaxis and therapy.