The role of cytokines and trophic factors in epiretinal membranes: involvement of signal transduction in glial cells.

Idiopathic epiretinal membranes (ERMs) in the macular region can cause a reduction in vision and sometimes recurs after surgical removal, but its pathogenic mechanisms are still unknown. On the other hand, the presence of secondary ERMs has been associated with various clinical conditions including proliferative diabetic retinopathy (PDR) and proliferative vitreoretinopathy (PVR). Recent studies have shown a significant association between clinical grades of PDR or PVR, and the expression levels of specific cytokines and/or growth factors in the vitreous fluid. Expression of these factors and their receptors are also observed in secondary ERMs. ERMs are composed of many cell types such as retinal pigment epithelial cells and vascular endothelial cells, however the role of glial cells is yet unclear. Interestingly, glial cells in ERMs express some trophic factor receptors and transcription factors, such as NF-kappaB, suggesting an involvement of glial signal transduction in the pathogenesis of ERMs. In this review, we summarize recent progress regarding the clinical and laboratory findings of ERMs.