Paper

Pathogenesis and Classification of Proliferative Diabetic Vitreoretinopathy
Peter Kroll, Eduardo Büchele Rodrigues, Steffen Hoerle

Department of Ophthalmology, Philipps University Marburg, Marburg, Germany

Address of Corresponding Author

Ophthalmologica 2007;221:78-94 (DOI: 10.1159/000098253)

  Key Words

• Proliferative diabetic vitreoretinopathy
• Proliferative diabetic retinopathy
• Diabetes
• Neovascularization
• Retina
• Vascular endothelial growth factor

  Abstract

Purpose: To review the current knowledge regarding the pathogenesis of proliferative diabetic vitreoretinopathy (PDVR) and to present recommendations for its clinical staging. Design: Focused literature review and authors' clinical experience. Results: Although several biochemical mediators may be responsible for the pathogenesis of PDVR, no common biochemical pathway exists. Of those mediators, vascular endothelial growth factor is the one most studied so far. However, since in proliferative diabetic retinopathy (PDR) the thickened posterior vitreous cortex is one of the main factors in the development of proliferations, a consequent shrinkage of the posterior vitreous cortex leads to hemorrhages and tractive retinal detachments. Therefore, PDR should be called PDVR. In consequence, the authors present a new morphological classification of PDVR. Conclusions: There is no consensus about the biochemical pathway responsible for the progression of PDVR. Although several classifications are described in the literature, the classification suggested here is important in the judgment of, the communication about and the therapy of diabetic retinopathy. Furthermore, it is the only reliable classification for predicting the surgical outcome in diabetics.

Copyright © 2007 S. Karger AG, Basel

  Author Contacts

Prof. Peter Kroll, MD
Klinik für Augenheilkunde
Robert-Koch-Strasse 4
DE-35033 Marburg (Germany)
Tel. +49 6421 286 2600, Fax +49 6421 286 5678, E-Mail krollp@med.uni-marburg.de

  Article Information

Number of Print Pages : 17
Number of Figures : 4, Number of Tables : 2, Number of References : 123