[Proliferative vitreoretinopathy--pathogenesis and therapy]. / Proliferative Vitreoretinopathie--Pathogenese und Therapie.

Proliferative vitreoretinopathy (PVR) is the most important complication of retinal detachment and vitreoretinal surgery. PVR is considered to represent a maladapted retinal wound repair process; proliferation of retinal and immune cells induces the formation of epiretinal membranes which cause tractional retinal detachment. This publication gives a brief overview on the pathogenesis and operative treatment of PVR as well as on adjunct pharmacological therapy which may target the components of the proliferative process. At the moment surgical approaches are the first choice for the treatment of PVR. Scleral buckling provides good anatomic results in the treatment of a PVR stage B or C1 / C2. From stage C 3 onwards vitrectomy offers advantage.

Activation of voltage-gated Na⁺ and Ca²âº channels is required for glutamate release from retinal glial cells implicated in cell volume regulation.

Gliotransmitters such as glutamate and ATP play an essential role in the prevention of the osmotic swelling of retinal glial (Müller) cells. It has been shown that vascular endothelial growth factor (VEGF) induces a Ca²âº-dependent release of glutamate from the cells [Wurm et al. (2008), J Neurochem 104:386-399]. In the present study, we investigated with cell swelling experiments on freshly isolated retinal glial cells of the rat whether activation of voltage-gated Na⁺ (Na(v)) and Ca²âº channels (VGCCs) is implicated in mediating the VEGF-induced release of glutamate. We found that the inhibitory effect of VEGF on the osmotic swelling of retinal glial cells, used as an indicator of glutamate release, is prevented in the presence of selective blockers of T-type VGCCs (kurtoxin, mibefradil, Ni²âº) and Na(v) channels (TTX, saxitoxin, phenytoin). In contrast, the swelling-inhibitory effect of glutamate, that is mediated by a downstream release of ATP, remained unaffected in the presence of the blockers. The cells displayed immunolabeling for VGLUT3, Ca(v)1.2, Ca(v)3.1, and Na(v)1.6. In addition to VEGF, various other receptor agonists including neuropeptide Y, progesterone, erythropoietin, and endothelin-1 evoked a VGCC- and Na(v) channel-dependent release of glutamate. It is concluded that activation of T-type VGCCs and Na(v) channels is implicated in mediating the ligand-induced release of glutamate from retinal glial cells of the rat. The involvement of VLGUTs might suggest that glutamate is released by vesicular exocytosis.

Tandem-pore domain potassium channels are functionally expressed in retinal (Müller) glial cells.

Tandem-pore domain (2P-domain) K+-channels regulate neuronal excitability, but their function in glia, particularly, in retinal glial cells, is unclear. We have previously demonstrated the immunocytochemical localization of the 2P-domain K+ channels TASK-1 and TASK-2 in retinal Müller glial cells of amphibians. The purpose of the present study was to determine whether these channels were functional, by employing whole-cell recording from frog and mammalian (guinea pig, rat and mouse) Müller cells and confocal microscopy to monitor swelling in rat Müller cells. TASK-like immunolabel was localized in these cells. The currents mediated by 2P-domain channels were studied in isolation after blocking Kir, K(A), K(D), and BK channels. The remaining cell conductance was mostly outward and was depressed by acid pH, bupivacaine, methanandamide, quinine, and clofilium, and activated by alkaline pH in a manner consistent with that described for TASK channels. Arachidonic acid (an activator of TREK channels) had no effect on this conductance. Blockade of the conductance with bupivacaine depolarized the Müller cell membrane potential by about 50%. In slices of the rat retina, adenosine inhibited osmotic glial cell swelling via activation of A1 receptors and subsequent opening of 2P-domain K+ channels. The swelling was strongly increased by clofilium and quinine (inhibitors of 2P-domain K+ channels). These data suggest that 2P-domain K+ channels are involved in homeostasis of glial cell volume, in activity-dependent spatial K+ buffering and may play a role in maintenance of a hyperpolarized membrane potential especially in conditions where Kir channels are blocked or downregulated.