Intravitreal Administration of Corticosteroids and Anti-Vascular Endothelial Growth Factor (Anti-VEGF) Agents to Prevent Proliferative Vitreoretinopathy in Open Globe Injury: A Review

Proliferative vitreoretinopathy (PVR) may occur as a complication in cases of open globe injury (OGI), where full-thickness injuries occur on the cornea or sclera. PVR arises due to excessive healing of vitreoretinal wound, significantly affecting poor visual outcomes. Although there have been advancements in vitreoretinal surgical techniques, effective prevention and management of PVR remain elusive. The use of pharmacological agents, especially intravitreal corticosteroids and anti-vascular endothelial growth factor (anti-VEGF) therapies has gained considerable attention. This article explores the phases of wound healing in OGI, highlighting the role of inflammatory responses in both wound healing and potential complications like PVR. Corticosteroids exhibit anti-inflammatory effects and reduce blood-retinal barrier (BRB) damage. Triamcinolone acetonide (TA), dexamethasone, and fluocinolone are among the most common locally administered corticosteroids. In addition, the role of anti-VEGF agents in PVR prevention is explored. VEGF plays a significant role in angiogenesis and neovascularization, making it a target for intervention. Various anti-VEGF agents, such as bevacizumab, ranibizumab, and aflibercept, are discussed for their potential to inhibit PVR progression. Intravitreal administration of these agents is a strategy to target PVR while minimizing systemic side effects. Even so, further clinical trials to establish the efficacy of intravitreal corticosteroids and anti-VEGF therapies in preventing PVR among OGI patients are still needed. PVR remains a complex challenge, and pharmacological approach is a promising treatment strategy to improve visual outcomes and quality of life for affected individuals.