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Br J Ophthalmol 1999;83:1219-1224 doi:10.1136/bjo.83.11.1219
  • Perspective

Molecular therapy in ocular wound healing

  1. M FRANCESCA CORDEIRO
  1. Wound Healing Research and Glaucoma Units, Institute of Ophthalmology and Moorfields Eye Hospital, London
  2. Department of Obstetrics and Gynaecology, University of Florida, Gainsville, USA
  3. Molecular Genetics Department, Institute of Ophthalmology and Institute of Child Health London
  4. Institute of Ophthalmology, London
  5. Wound Healing Research and Glaucoma Units, Institute of Ophthalmology and Moorfields Eye Hospital, London
    1. GREGORY S SCHULTZ
    1. Wound Healing Research and Glaucoma Units, Institute of Ophthalmology and Moorfields Eye Hospital, London
    2. Department of Obstetrics and Gynaecology, University of Florida, Gainsville, USA
    3. Molecular Genetics Department, Institute of Ophthalmology and Institute of Child Health London
    4. Institute of Ophthalmology, London
    5. Wound Healing Research and Glaucoma Units, Institute of Ophthalmology and Moorfields Eye Hospital, London
      1. ROBIN R ALI
      1. Wound Healing Research and Glaucoma Units, Institute of Ophthalmology and Moorfields Eye Hospital, London
      2. Department of Obstetrics and Gynaecology, University of Florida, Gainsville, USA
      3. Molecular Genetics Department, Institute of Ophthalmology and Institute of Child Health London
      4. Institute of Ophthalmology, London
      5. Wound Healing Research and Glaucoma Units, Institute of Ophthalmology and Moorfields Eye Hospital, London
        1. SHOMI S BHATTACHARYA
        1. Wound Healing Research and Glaucoma Units, Institute of Ophthalmology and Moorfields Eye Hospital, London
        2. Department of Obstetrics and Gynaecology, University of Florida, Gainsville, USA
        3. Molecular Genetics Department, Institute of Ophthalmology and Institute of Child Health London
        4. Institute of Ophthalmology, London
        5. Wound Healing Research and Glaucoma Units, Institute of Ophthalmology and Moorfields Eye Hospital, London
          1. PENG T KHAW
          1. Wound Healing Research and Glaucoma Units, Institute of Ophthalmology and Moorfields Eye Hospital, London
          2. Department of Obstetrics and Gynaecology, University of Florida, Gainsville, USA
          3. Molecular Genetics Department, Institute of Ophthalmology and Institute of Child Health London
          4. Institute of Ophthalmology, London
          5. Wound Healing Research and Glaucoma Units, Institute of Ophthalmology and Moorfields Eye Hospital, London
          1. Dr M Francesca Cordeiro, Wound Healing Research and Glaucoma Units, Department of Pathology, Department of Molecular Genetics, Moorfields Eye Hospital and Institute of Ophthalmology, Bath Street, London EC1V 9EL

            Recent advances in molecular cell biology have revolutionised our understanding of medical diseases and provided new and alternative strategies for developing treatments. Here we review the spectrum of molecular therapies that are either currently available or have potential application as agents that are able to modulate the wound healing response in the eye. For the purposes of this review, we define molecular therapy as the targeting of specific molecules known to be involved in the processes of wound healing. This may be at the level of either protein or gene expression.

            Ocular wound healing

            The process of wound healing is involved in either the pathogenesis or failure of treatment of many of the major blinding or visually disabling conditions in the world today. It is implicated in scarring diseases throughout the eye, some examples of which are described below.

            The conjunctival wound healing response is important in many ocular conditions such as pemphigoid, trachoma, and chronic cicatrisation, where the development of complications arises from the disruption of the ocular surface.1 It is also a major determinant of outcome following glaucoma filtration and squint surgery.2The severity and extent of clinical disease are closely related to the degree of conjunctival scarring. Another example of scarring is that occurring in the cornea after excimer laser photorefractive keratectomy (PRK), giving rise to symptoms of haze and resulting, in some cases, in a reduction of the best corrected visual acuity.3 4 The scarring condition of proliferative vitreoretinopathy (PVR) accounts for 7–10% of surgical failures in primary retinal detachment repair procedures5 6 and is responsible for producing significant visual morbidity and blindness. It is characterised by the development of fibrosing and proliferating cellular membranes on the vitreous and retinal surfaces that contract and cause irreparable tractional retinal detachments.

            Molecular and cellular events in wound healing

            The complex process of wound healing …

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