Abstract
Proliferative vitreoretinopathy (PVR) is still the major cause of failure in retinal detachment (RD) surgery. It is believed that down-regulation in the p53 pathway could be an important key in PVR pathogenesis. The purpose was to evaluate the impact of T309G MDM2 polymorphism (rs2279744) in PVR. Distribution of T309G MDM2 genotypes among European subjects undergoing RD surgery was evaluated. Proportions of genotypes between subsamples from different countries were analyzed. Also, a genetic interaction between rs2279744 in MDM2 and rs1042522 in p53 gene was analyzed. Significant differences were observed comparing MDM2 genotype frequencies at position 309 of intron 1 between cases (GG: 21.6%, TG: 54.5%, TT: 23.8%) and controls (GG: 7.3%, TG: 43.9%, TT: 48.7%). The proportions of genotypes between sub-samples from different countries showed a significant difference. Distribution of GG genotype revealed differences in Spain (35.1–53.0)/(22.6–32.9), Portugal (39.0–74.4)/(21.4–38.9), Netherlands (40.6–66.3)/(25.3–38.8) and UK (37.5–62.4)/(23.3–34.2). The OR of G carriers in the global sample was 5.9 (95% CI: 3.2 to 11.2). The OR of G carriers from Spain and Portugal was 5.4 (95% CI: 2.2–12.7), whereas in the UK and the Netherlands was 7.3 (95% CI: 2.8–19.1). Results indicate that the G allele of rs2279744 is associated with a higher risk of developing PVR in patients undergoing a RD surgery. Further studies are necessary to understand the role of this SNP in the development of PVR.
Highlights
Proliferative vitreoretinopathy (PVR) is still the major cause of failure in retinal detachment (RD) surgery [1], affecting 5% to 10% of RD and accounting for approximately 75% of all primary failures after RD surgery [1,2]
Growth factors and cytokines in the vitreous cavity seem to be responsible for retinal pigment epithelium cells (RPE) migration, metaplasia and proliferation [11,12,13], which can result in the development of epi and subretinal membranes which are some of the characteristic clinical features of PVR
A significant association in patients with history of PVR in the fellow eye was found in the cases group
Summary
Proliferative vitreoretinopathy (PVR) is still the major cause of failure in retinal detachment (RD) surgery [1], affecting 5% to 10% of RD and accounting for approximately 75% of all primary failures after RD surgery [1,2] It is considered an abnormal wound-healing process induced by a retinal break allowing the posterior escape of retinal pigment epithelium cells (RPE) into a pro-inflammatory vitreous environment [3,4,5,6,7]. Tangential contraction of the membranes leads to reduced internal diameter of the retina and subsequent tension which rapidly develops into RD once a break allows ingress of subretinal fluid [14,15,16] Some of those growth factors are responsible of the glial cell hypertrophy causing important changes inside of the retinal tissue and inducing a shortening of the neuroretina, the most severe form of PVR [17]
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