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Preretinal Fibrosis

Disease Details

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Description: Preretinal fibrosis, also known as epiretinal membrane (ERM), is a condition where a thin layer of fibrous tissue forms on the surface of the retina, potentially causing vision distortions or blurriness.
Type: Preretinal fibrosis, more commonly referred to as epiretinal membrane (ERM) or macular pucker, is not typically considered a genetic disorder. Instead, it is usually an acquired condition. Therefore, there is no specific type of genetic transmission associated with preretinal fibrosis. It commonly occurs due to aging, retinal detachment, or other eye conditions, rather than through hereditary factors.
Signs And Symptoms: Preretinal fibrosis, often associated with conditions such as epiretinal membrane or macular pucker, can present with various signs and symptoms, which may include:

- Blurred or distorted vision, such as wavy or warped lines
- Difficulty reading or seeing fine details
- Double vision in the affected eye
- A gray area or blurring in central vision
- A sensation of a film over the eye or difficulty performing detailed tasks like threading a needle

In some cases, preretinal fibrosis may be asymptomatic and detected only during an eye examination.
Prognosis: Preretinal fibrosis, also known as epiretinal membrane (ERM), generally has a variable prognosis. Many cases remain stable and do not significantly impact vision, particularly if symptoms are mild. However, in more severe cases, it can lead to visual distortion and decreased visual acuity, potentially necessitating surgical intervention via a procedure called vitrectomy to improve vision. Regular monitoring by an ophthalmologist is crucial to manage and assess disease progression.
Onset: Preretinal fibrosis, also known as epiretinal membrane (ERM), typically develops gradually with age. It is more common in individuals over the age of 50. The condition can be associated with aging, retinal detachment, inflammation, vascular diseases in the retina, or trauma, although often it occurs without a clear cause. Early stages may be asymptomatic, but over time patients might experience visual disturbances such as blurred or distorted vision.
Prevalence: Preretinal fibrosis, also known as epiretinal membrane (ERM), has a prevalence of about 2% to 20% in the general population. The prevalence increases with age, particularly affecting those over the age of 50.
Epidemiology: Preretinal fibrosis, also known as epiretinal membrane (ERM), is a condition characterized by the formation of a fibrocellular membrane on the inner surface of the retina.

**Epidemiology:**
- **Prevalence:** The condition is relatively common, with prevalence rates increasing with age. Studies estimate that around 2-20% of the population over the age of 60 may develop some form of ERM.
- **Risk Factors:** Age is the most significant risk factor. Other risk factors include previous eye surgeries, retinal vascular diseases (like diabetic retinopathy), posterior vitreous detachment, uveitis, and trauma.
- **Gender:** There is no significant gender predisposition reported.

Note: "nan" is not applicable in this context as it does not provide relevant information regarding the epidemiology of preretinal fibrosis.
Intractability: Preretinal fibrosis, also known as epiretinal membrane (ERM), is not generally considered intractable. Treatment options are available, including observation for mild cases and surgical intervention, such as vitrectomy, for more severe cases that significantly affect vision. The success of treatment varies depending on the individual case and the extent of the fibrosis.
Disease Severity: Preretinal fibrosis, also known as epiretinal membrane (ERM), varies in severity. It can range from mild cases, which might not significantly affect vision, to more severe cases where vision becomes blurred and distorted. In severe instances, it can lead to significant vision impairment and necessitate surgical intervention. The condition often progresses slowly, so regular monitoring by an ophthalmologist is recommended.
Healthcare Professionals: Disease Ontology ID - DOID:2006
Pathophysiology: Preretinal fibrosis, also known as epiretinal membrane (ERM), involves the formation of a fibrous layer on the surface of the retina, particularly the macula. Pathophysiologically, it occurs when cells such as glial cells, retinal pigment epithelial cells, or fibrocytes proliferate and migrate to the retinal surface, forming a membrane. This membrane can contract and cause distortion or wrinkling of the retina, leading to visual disturbances such as blurred vision, metamorphopsia (distorted vision), or difficulty reading. Factors contributing to its development can include aging, retinal detachment, inflammation, or vascular diseases like diabetic retinopathy.
Carrier Status: Preretinal fibrosis, also known as epiretinal membrane, is a condition involving the development of a fibrous layer on the retinal surface. Carrier status does not typically apply to this condition, as it is not an inherited genetic disorder. It is usually associated with aging, retinal tears, or other eye diseases.
Mechanism: Preretinal fibrosis involves the formation of fibrotic tissue on the surface of the retina, which can lead to visual impairment.

**Mechanism:**
Preretinal fibrosis typically occurs as a result of proliferative vitreoretinopathy (PVR), diabetic retinopathy, or other retinal conditions that cause cellular proliferation and migration on the retinal surface. The process generally involves the contraction of newly formed fibrous tissue, leading to retinal distortion or detachment.

**Molecular Mechanisms:**
1. **Growth Factors and Cytokines:** Increased levels of growth factors such as vascular endothelial growth factor (VEGF) and transforming growth factor-beta (TGF-β) play a significant role. These factors promote the proliferation, migration, and differentiation of retinal pigment epithelial (RPE) cells and glial cells.

2. **Extracellular Matrix (ECM) Production:** Fibroblasts and myofibroblasts produce excessive ECM components like collagen, fibronectin, and laminin, contributing to tissue fibrosis.

3. **Cellular Signaling Pathways:** Pathways such as the TGF-β/Smad signaling, the Wnt/β-catenin pathway, and the mitogen-activated protein kinase (MAPK) pathway are crucial in regulating the cellular behaviors contributing to fibrosis.

4. **Inflammatory Response:** Chronic inflammation leads to the release of inflammatory cytokines (e.g., TNF-α, IL-1β) that further stimulate fibroblastic activity and ECM deposition.

5. **Oxidative Stress:** Reactive oxygen species (ROS) can modify cellular signaling and exacerbate fibrotic changes through oxidative damage to cellular components.

Together, these molecular mechanisms underlie the pathophysiological process of preretinal fibrosis, contributing to its progression and the associated visual complications.
Treatment: Preretinal fibrosis, also known as epiretinal membrane (ERM), is treated through monitoring and surgical intervention if necessary. In cases where vision is significantly affected or if there are distressing symptoms, a vitrectomy surgery to remove the membrane can be performed. If the symptoms are mild, regular monitoring by an ophthalmologist may be recommended.
Compassionate Use Treatment: Preretinal fibrosis, often associated with conditions like epiretinal membrane (ERM), macular pucker, or retinal scarring, typically requires intervention only if it significantly impairs vision. While the primary treatment is surgical, involving procedures like vitrectomy and membrane peeling, there are some off-label, compassionate use, or experimental treatments that might be considered in certain cases.

1. **Anti-VEGF Therapy:** Primarily used in treating wet age-related macular degeneration, anti-VEGF (vascular endothelial growth factor) injections like bevacizumab (Avastin) have been explored for their potential to reduce macular edema associated with preretinal fibrosis.

2. **Steroid Injections:** Intraocular steroids such as triamcinolone acetonide, though not specifically approved for preretinal fibrosis, might be used off-label to reduce inflammation and macular edema.

3. **Ocriplasmin:** An enzyme that can dissolve protein structures within the vitreous, ocriplasmin has been investigated for treating conditions that cause vitreoretinal traction, which is sometimes related to preretinal fibrosis.

4. **Experimental Pharmacologic Agents:** Research is ongoing into various pharmacologic agents that may prevent or reduce fibrosis, such as inhibitors of specific fibrogenic pathways. These treatments are still in clinical trial phases and are not yet widely available.

These treatments are generally considered when conventional methods are unsuitable or have failed, and their use should be carefully considered by a specialist, weighing potential benefits and risks.
Lifestyle Recommendations: For preretinal fibrosis:

Lifestyle Recommendations:
1. **Monitor Vision Changes**: Regularly check for any changes in vision and report them to an ophthalmologist promptly.
2. **Protect Your Eyes**: Wear sunglasses to protect your eyes from UV radiation and use protective eyewear during activities that could cause eye injury.
3. **Manage Chronic Conditions**: Control underlying conditions such as diabetes and hypertension through proper medication, diet, and exercise.
4. **Healthy Diet**: Maintain a balanced diet rich in leafy greens, fish, and fruits to support overall eye health.
5. **Quit Smoking**: Avoid smoking, as it can exacerbate eye diseases and contribute to further vision deterioration.
6. **Regular Eye Exams**: Have comprehensive eye exams regularly to monitor the condition and any potential progression.

If you have any other specific information you need or questions, feel free to ask.
Medication: There are no specific medications for treating preretinal fibrosis. Management typically involves monitoring the condition, and in severe cases, surgical intervention such as pars plana vitrectomy may be considered to remove the epiretinal membrane causing the fibrosis.
Repurposable Drugs: Preretinal fibrosis, also known as epiretinal membrane (ERM), typically involves the formation of a fibrous layer on the surface of the retina, which can distort vision. While no specific drugs are officially repurposed for the treatment of preretinal fibrosis, certain medications are sometimes used off-label to manage related symptoms or underlying conditions that may contribute to the development of the condition.

1. **Anti-VEGF agents (e.g., Bevacizumab)**: These could be considered in cases where preretinal fibrosis is associated with conditions that involve neovascularization, like diabetic retinopathy or age-related macular degeneration.

2. **Corticosteroids (e.g., Triamcinolone acetonide)**: These may be used to reduce inflammation and edema that could potentially accompany the fibrotic changes.

3. **Nonsteroidal anti-inflammatory drugs (NSAIDs)**: Topical or systemic NSAIDs might help manage inflammation.

Note that the definitive treatment for significant visual impairment due to preretinal fibrosis usually involves surgical intervention, specifically a procedure called vitrectomy, where the membrane is peeled away from the retina.
Metabolites: Preretinal fibrosis, also known as epiretinal membrane (ERM), is not typically associated with specific metabolites directly. It is characterized by the formation of a fibrous membrane on the inner surface of the retina, often leading to visual impairment. The condition itself is more closely related to cell proliferation and extracellular matrix production rather than specific metabolites. Diagnostic and therapeutic approaches focus on imaging techniques (like optical coherence tomography) and surgical intervention (such as vitrectomy), rather than metabolic analysis. Nanotechnology applications are still in research stages and primarily experimental.
Nutraceuticals: Nutraceuticals, which are food-derived products with potential health benefits, have limited evidence for the treatment of preretinal fibrosis. This condition, also known as epiretinal membrane (ERM), typically requires clinical interventions such as surgery for significant visual impairment. Some general eye health supplements, including antioxidants like vitamins C and E, zinc, and lutein, may support overall retinal health, but their specific efficacy on preretinal fibrosis is not well-documented. Consult with a healthcare professional for personalized advice.
Peptides: Peptides and nanoparticles (nan) are emerging areas of interest in the treatment of preretinal fibrosis. Peptides can potentially target specific pathways involved in fibrosis formation, thereby inhibiting the progression of the disease. Nanoparticles can be used as delivery systems for drugs or therapeutic agents, ensuring targeted and sustained release to the affected retinal area. These approaches are still under research and development, aiming to improve efficacy and reduce side effects in the treatment of preretinal fibrosis.