Updates on the Mechanism and Management of Pterygium: A Brief Review

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  •   Fazella Kirara Sakti

Abstract

Pterygium is an ocular surface disease characterized by invasive fibrovascular growth due to pathological proliferation and inflammation on the conjunctival and corneal tissue. Its occurrence has been associated with chronic ultraviolet exposure, thus becoming one of the most common eye problems in tropical regions worldwide. Although pterygium rarely causes severe visual disturbances or blindness, it often becomes a distressing problem because of the high recurrence rate and unsatisfactory cosmetic outcomes, despite receiving removal management. In recent decades, studies regarding molecular mechanisms and management of pterygium have been advanced. This review provides a brief update on the mechanism and management to achieve more optimal and satisfactory pterygium therapeutic approaches.


Keywords: diagnosis, management, pterygium, review

References

L. Liu, J. Wu, J. Geng, Z. Yuan, D. Huang, “Geographical prevalence and risk factors for pterygium: a systematic review and metaanalysis,” BMJ Open, vol. 3, no. 11, pp. e003787, Nov 2013.

R. Asokan, R. S. Venkatasubbu, L. Velumuri, V. Lingam, R. George, “Prevalence and associated factors for pterygium and pinguecula in a South Indian population,” Ophthalmic Physiol. Opt., vol. 32, no. 1, pp. 39-44, Jan 2012.

F. Rezvan, M. Khabazkhoob, E. Hooshman, A. Yekta, M. Saatchi, H. Hashemi, “Prevalence and risk factors of pterygium: a systematic review and meta-analysis,” Surv. Ophthalmol., vol. 63, no. 5, pp. 719-735, Sep-Oct 2018.

R. D. Johnson, V. C. Pai, R. H. Hoft, “Historical approaches to pterygium surgery, including bare sclera and adjunctive beta radiation techniques,” in Pterygium: Techniques and Technologies for Surgical Success, J. A. Hovanesian, Ed. Thorofare, NJ: Slack Incorporated, pp. 27-36.

M. Caldwell, L. Hirst, M. A. Woodward, N. Nallasamy, V. Bunya. (March 2021). Pterygium. American Academy of Ophthalmology [Online]. Available: https://eyewiki.aao.org/Pterygium.

E. T. Detorakis, D. A. Spandidos, “Pathogenetic mechanisms and treatment options for ophthalmic pterygium: trends and perspectives (review),” Int. J. Mol. Med., vol. 23, no. 4, pp. 439-447, Apr 2009.

L. W. Hirst, “The treatment of pterygium,” Surv. Ophthalmol., vol. 48, no. 2, pp. 145-180, Mar-Apr 2003.

J. P. Fisher. (July 2019). Pterygium. Medscape [Online]. Available: https://emedicine.medscape.com/article/1192527-overview.

H. A. Ginger-Eke, C. E. Ogbonnaya, C. N. Ezisi, “Pterygium: recent trends and perspectives-a review of pathogenesis and current management options,” Niger. J. Ophthalmol., vol. 26, no. 2, pp. 89-98, Jan 2018.

W. P. Zhou, Y. F. Zhu, B. Zhang, W. Y. Qiu, Y. F. Yao, “The role of ultraviolet radiation in the pathogenesis of pterygia (review),” Mol. Med. Rep., vol. 14, no. 1, pp. 3-15, Jul 2016.

J. C. S. Yam, A. K. H. Kwok, “Ultraviolet light and ocular diseases,” Int. Ophthalmol., vol. 34, pp. 383-400, Apr 2014.

M. Zhang, Z. Liu, Y. Xie, “The study on the expression of keratin proteins in pterygial epithelium,” Yan Ke Xue Bao, vol. 16, no. 1, pp. 48-52, Mar 2000.

Y. Dake, R. Mukae, Y. Soda, M. Kaneko, T. Amemiya, “Immunohistochemical localization of collagen types I, II, III, and IV in pterygium tissues,” Acta Histochem., vol. 87, no. 1, pp. 71-74, 1989.

N. D. Girolamo, P. McCluskey, A. Lloyd, M. T. Coroneo, D. Wakefield, “Expression of MMPs and TIMPs in human pterygia and cultured pterygium epithelial cells,” Invest. Ophthalmol. Vis. Sci., vol. 41, no. 3, pp. 671-679, Mar 2000.

C. Pérez-Rico, G. Pascual, S. Sotomayor, M. Á. Montes-Mollón, C. Trejo, T. Sasaki, et al., “Tropoelastin and fibulin overexpression in the subepithelial connective tissue of human pterygium,” Am. J. Ophthalmol., vol. 151, no. 1, pp. 44-52, Jan 2011.

N. D. Girolamo, R. K. Kumar, M. T. Coroneo, D. Wakefield, “UVB-mediated induction of interleukin-6 and -8 in pterygia and cultured human pterygium epithelial cells,” Invest. Ophthalmol. Vis. Sci., vol. 43, no. 11, pp. 3430-3437, Nov 2002.

Z. M. Huang, Z. Q. Zhang, Y. F. Li, H. Du, X. M. Yao, “Interleukine-l alpha expression in primary and recurrent pterygium,” Chin. J. Pract. Ophthalmol., vol. 28, no. 4, pp. 407-409, 2010.

B. Jabarin, A. Solomon, R. Amer, “Interleukin-17 and its correlation with vascular endothelial growth factor expression in ocular surface pathologies: a histologic study,” Eur. J. Ophthalmol., vol. 26, no. 4, pp. 283-286, Jun 2016.

N. D. Girolamo, J. Chui, M. T. Coroneo, D. Wakefield D, “Pathogenesis of pterygia: role of cytokines, growth factors, and matrix metalloproteinases,” Prog. Retin. Eye Res., vol. 23, no. 2, pp. 195-228, Mar 2004.

E. Bianchi, F. Scarinci, C. Grande, R. Plateroti, P. Plateroti, A. M. Plateroti, et al., “Immunohistochemical profile of VEGF, TGF-β and PGE2 in human pterygium and normal conjunctiva: experimental study and review of the literature,” Int. J. Immunopathol. Pharmacol., vol. 25, no. 3, pp. 607-615, Jul-Sep 2012.

J. Fukuhara, S. Kase, T. Ohashi, R. Ando, Z. Dong, K. Noda, et al., “Expression of vascular endothelial growth factor C in human pterygium,” Histochem. Cell Biol., vol. 139, no. 2, pp. 381-389, Feb 2013.

M. Mood, S. K. Mittal, S. Kishore, A. Singh, N. Gupta, R. Rana, “Expression of p53 and Ki-67 proteins in patients with increasing severity and duration of pterygium,” Indian J. Ophthalmol., vol. 69, no. 4, pp. 847-850, Apr 2021.

F. S. Ramalho, C. Maestri, L. N. Z. Ramalho, A. Ribeiro-Silva, E. Romão, “Expression of p63 and p16 in primary and recurrent pterygia,” Graefes. Arch. Clin. Exp. Ophthalmol., vol 244, no. 10, pp. 1310-1314, Oct 2006.

S. Kase, S. Takahashi, I. Sato, K. Nakanishi, K. Yoshida, S. Ohno, “Expression of p27(KIP1) and cyclin D1, and cell proliferation in human pterygium,” Br. J. Ophthalmol., vol. 91, no. 7, pp. 958-961, Jul 2007.

L. Tong, “Expression of p27(KIP1) and cyclin D1, and cell proliferation in human pterygium,” Br. J. Ophthalmol., vol. 92, no. 1, pp. 157, Jan 2008.

K. Liang, Z. Jiang, B. Ding, P. Cheng, D. Huang, L. Tao, “Expression of cell proliferation and apoptosis biomarkers in pterygia and normal conjunctiva,” Mol. Vis., vol. 17, pp. 1687-1693, Jun 2011.

E. Süren, D. Nergiz, B. Bilgin, D. T. Çoban, Z. Akgündüz, C. Sadullahoğlu, et al., “The role of cyclin D1, BCL-2, p53 and Ki-67 in epithelial cells in the etiopathogenesis of pterygium,” Indian J. Pathol. Microbiol., vol. 64, no. 2, pp. 238-242, Apr 2021.

C. Maxia, M. T. Perra, P. Demurtas, L. Minerba, D. Murtas, F. Piras, et al., “Expression of survivin protein in pterygium and relationship with oxidative DNA damage,” J. Cell Mol. Med., vol. 12, no. 6A, pp. 2372-2380, Dec 2008.

Y. Xu, L. Zhang, D. Zou, Z. Liu, X. Shang, H. Wu, et al., “Differential expression and function of survivin during the progress of pterygium,” Invest. Ophthalmol. Vis. Sci., vol. 55, no. 12, pp. 8480-8487, Dec 2014.

Y. Liu, H. Xu, M. An, “mTORC1 regulates apoptosis and cell proliferation in pterygium via targeting autophagy and FGFR3,” Sci. Rep., vol. 7, no. 7339, Aug 2017.

Y. H. Cui, H. Y, Li, Z. X. Gao, N. Liang, S. S. Ma, F. J. Meng, et al., “Regulation of apoptosis by miR-122 in pterygium via targeting Bcl-w,” Invest. Ophthalmol. Vis. Sci., vol. 57, no. 8, pp. 3723-3730, Jul 2016.

D. Pagoulatos, N. Pharmakakis, J. Lakoumentas, M. Assimakopoulou, “Ηypoxia-inducible factor-1α, von Hippel-Lindau protein, and heat shock protein expression in ophthalmic pterygium and normal conjunctiva,” Mol. Vis., vol. 20, pp. 441-457, Mar 2014.

A. S. Dogan, E. Onder, A. T. Arikok, T. Bicer, C. Gurdal, “Claudin-1 expressions decrease in pterygium with respect to normal conjunctiva,” Cutan. Ocul. Toxicol., vol. 35, no. 4, pp. 315-318, Dec 2016.

U. Beden, M. Irkec, D. Orphan, M. Orphan, “The roles of T-lymphocyte subpopulations (CD4 and CD8), intercellular adhesion molecule-1 (ICAM-1), HLA-DR receptor, and mast cells in etiopathogenesis of pterygium,” Ocul. Immunol. Inflamm., vol. 11, no. 2, pp. 115-122, Jun 2003.

S. Kase, M. Osaki, I. Sato, S. Takanashi, K. Nakanishi, K. Yoshida, et al., “Immunolocalisation of E-cadherin and beta-catenin in human pterygium,” Br. J. Ophthalmol., vol. 91, no. 9, pp. 1209-1212, Sep 2007.

A. Alpay, S. H. Uğurbaş, B. Erdoğan, “Comparing techniques for pterygium surgery,” Clin. Ophthalmol., vol. 3, pp. 69-74, 2009.

S. I. Van Acker, M. Haagdorens, E. Roelant, J. Rozema, T. Possemiers, V. Van Gerwen, “Pterygium pathology: a prospective case-control study on tear film cytokine levels, vol. 2019, no. 9416262, Nov 2019.

D. Hacıoğlu, H. Erdöl, “Developments and current approaches in the treatment of pterygium,” Int. Ophthalmol., vol. 37, no. 4, pp. 1073-1081, Aug 2017.

J. Parker. (Januart 2021). Surgical approaches to pterygium. Review of Ophthalmology [Online]. Available: https://www.reviewofophthalmology.com/article/surgical-approaches-to-pterygium.

F. Pereira, H. F. Shiroma, M. G. Urias, V. H. Yamada, A. A. S. Lima, A. L. Hofling-Lima, et al., “Pilot study comparing topical anesthetic agents in pterygium surgery: subconjunctival injection versus 2% lidocaine gel versus 5% lidocaine gel,” Cornea, vol. 37, no. 2, pp. 194-198, Feb 2018.

H. Oksuz, C. Tamer, “Efficacy of lidocaine 2% gel in pterygium surgery,” Acta Ophthalmol. Scand., vol. 83, pp. 206-209, 2005.

V. Damle, “A study to compare conjunctival autografting with sutures and glue free sutureless technique after primary pterygium excision,” Int. J. Sci. Study, vol. 5, no. 9, pp. 142-147, 2017.

S. K. Singh, “Pterygium: epidemiology prevention and treatment,” Community Eye Health, vol. 30, no. 99, pp. S5-S6, Jan 2017.

K. C. Apaydin, Y. Duranoglu, O. Saka, N. Demirbas, “Argon laser treatment of pterygium,” Ann. Ophthalmol., vol. 34, pp. 26-29, Mar 2002.

D. Chen, X. Liu, Q. Long, Z. Wang, Y. Li, “Effects of excimer laser phototherapeutic keratectomy in limbal-conjunctival autograft transplantation for recurrent pterygium: a retrospective case control study,” BMC Ophthalmol., vol. 19, no. 238, Nov 2019.

K. H. Chen, W. M. Hsu, “Intraoperative ethanol treatment as an adjuvant therapy of pterygium excision,” Int. J. Biomed. Sci., vol. 2, no. 4, pp. 414-421, Dec 2006.

D. Todorovic, T. Sarenac-Voluvic, S. Sreckovic, S. Jovanovic, K. Janicijevic, Z. Todorovic, “Updates on the treatment of pterygium,” Serbian J. Exp. Clin. Res., vol. 17, no. 3, pp. 257-261, Sept 2016.

A. L. Young, P. M. Tam, G. Y. Leung, L. L. Cheng, P. T. Lam, D. S. Lam, et al., “Prospective study on the safety and efficacy of combined conjunctival rotational autograft with intraoperative 0.02% mitomycin C in primary pterygium excision,” Cornea, vol. 28, no. 2, pp. 168-169, Feb 2009.

J. Frucht-Pery, F. Raiskup, M. Ilsar, D. Landau, F. Orucov, A. Solomon, “Conjunctival autografting combined with low dose mitomycin C for prevention of primary pterygium recurrence,” Am. J. Ophthalmol., vol. 141, no. 6, pp. 1044-1050, Jun 2006.

G. Koranyi, D. Artzen, S. Seregard, E. D. Kopp, “Intraoperative mitomycin C versus autologous conjunctival autograft in surgery of primary pterygium with four-year follow up,” Acta Ophthalmol., vol. 90, no. 3, pp. 266-270, May 2012.

M. C. Biswas, C. Shaw, R. Mandal, “Treatment of pterygium with conjunctival limbal autograft and mitomycin C - a comparative study,” J. Indian Med. Assoc., vol. 105, no. 4, pp. 202-204, Apr 2007.

C. C. Teng, N. N. Patel, L. Jacobson, “Effect of subconjunctival bevacizumab on primary pterygium,” Cornea, vol. 28, no. 4, pp. 468-470, May 2009.

A. Shenasi, F. Mousave, S. Shoa-Ahari, B. Rahimi-Ardabili, R. F. Fouladi, “Subconunctival bevacizumab immediately after excision of primary pterygium: the first clinical trial,” Cornea, vol. 30, no. 11, pp. 1219-1222, Nov 2011.

L. R. Stival, A. M. Lago, M. N. Figueiredo, R. H. Bittar, M. L. Machado, J. J. Nassaralla Junior, “Efficacy safety of subconjunctival bevacizumab for recurrent pterygium,” Arg. Bras. Oftalmol., vol. 77, no. 1, pp. 4-7, Jun 2013.

C. Akarsu, P. Taner, A. Ergin, “5-Fluorouracil as chemoadjuvant for primary pterygium surgery: preliminary report,” Cornea, vol. 22, no. 6, pp. 522-526, Aug 2003.

P. Prabhasawat, N. Tesavibul, K. Leelapatranura, T. Phonjan, “Efficacy of subconjunctival 5-fluorouracil and triamcinolone injection in impending recurrent pterygium,” Ophthalmology, vol. 113, no. 7, pp. 1102-1109, Jul 2006.

K. Kampitak, W. Leelewongtawun, S. Leeamornsiri, W. Suphachearaphan, “Role of artificial tears in reducing the recurrence of pterygium after surgery: a prospective randomized controlled trial,” Acta Ophthalmol., vol. 95, no. 3, pp. e227-e229, May 2017.

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How to Cite
Sakti, F. K. (2021). Updates on the Mechanism and Management of Pterygium: A Brief Review. European Journal of Medical and Health Sciences, 3(4), 6-11. https://doi.org/10.24018/ejmed.2021.3.4.949