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Epithelial Downgrowth

Abstract
Epithelial downgrowth is a rare, but vision-threatening, complication of penetrating ocular trauma or intraocular surgery. In this disease, epithelial cells enter the anterior chamber and proliferate into intraocular structures. Stratified squamous epithelium is not normally present in the interior of the eye but can grow into nearly any intraocular structure. Epithelialization can appear in three forms: pearls, cysts, and sheets.[1] The sheet-like, diffuse form is the most common and most aggressive and more frequently leads to complications like secondary glaucoma. The cystic form, on the other hand, has a more benign course.[2] The natural course of epithelial downgrowth, however, leads to extensive epithelial invasion resulting in inflammation, secondary glaucoma, hemorrhage, and ultimately permanent vision loss or loss of the eye.[3] This article presents a brief overview of the etiology, pathophysiology, and risk factors for epithelial downgrowth with a broader discussion of the many diagnostic and therapeutic options, along with the advantages and disadvantages of each. Of note, the terms epithelial downgrowth and epithelial ingrowth are sometimes used interchangeably in the literature. However, this article will not discuss epithelial ingrowth that occurs after procedures such as LASIK where there is ingrowth of epithelium into the corneal flap interface.    Epithelial downgrowth should also be distinguished from fibrous downgrowth. These two conditions are quite similar in terms of etiology, risk factors, and complications and are often managed the same way. However, there are subtle but important differences between the two that will be further discussed in the “Differential Diagnosis” section.

Publisher

StatPearls Publishing
Treasure Island (FL)

Language

eng

PubMed ID

32644422

Citation

Moshirfar M, Hall MG, Ronquillo Y: Epithelial Downgrowth. StatPearls. StatPearls Publishing, 2020, Treasure Island (FL).
Moshirfar M, Hall MG, Ronquillo Y. Epithelial Downgrowth. StatPearls. StatPearls Publishing; 2020.
Moshirfar M & Hall MG & Ronquillo Y. (2020). Epithelial Downgrowth. In StatPearls. Treasure Island (FL): StatPearls Publishing
Moshirfar M, Hall MG, Ronquillo Y. Epithelial Downgrowth. StatPearls. Treasure Island (FL): StatPearls Publishing; 2020.
* Article titles in AMA citation format should be in sentence-case
TY - CHAP T1 - Epithelial Downgrowth BT - StatPearls A1 - Moshirfar,Majid, AU - Hall,MacGregor, AU - Ronquillo,Yasmyne, Y1 - 2020/01// PY - 2020/7/10/pubmed PY - 2020/7/10/medline PY - 2020/7/10/entrez N2 - Epithelial downgrowth is a rare, but vision-threatening, complication of penetrating ocular trauma or intraocular surgery. In this disease, epithelial cells enter the anterior chamber and proliferate into intraocular structures. Stratified squamous epithelium is not normally present in the interior of the eye but can grow into nearly any intraocular structure. Epithelialization can appear in three forms: pearls, cysts, and sheets.[1] The sheet-like, diffuse form is the most common and most aggressive and more frequently leads to complications like secondary glaucoma. The cystic form, on the other hand, has a more benign course.[2] The natural course of epithelial downgrowth, however, leads to extensive epithelial invasion resulting in inflammation, secondary glaucoma, hemorrhage, and ultimately permanent vision loss or loss of the eye.[3] This article presents a brief overview of the etiology, pathophysiology, and risk factors for epithelial downgrowth with a broader discussion of the many diagnostic and therapeutic options, along with the advantages and disadvantages of each. Of note, the terms epithelial downgrowth and epithelial ingrowth are sometimes used interchangeably in the literature. However, this article will not discuss epithelial ingrowth that occurs after procedures such as LASIK where there is ingrowth of epithelium into the corneal flap interface.    Epithelial downgrowth should also be distinguished from fibrous downgrowth. These two conditions are quite similar in terms of etiology, risk factors, and complications and are often managed the same way. However, there are subtle but important differences between the two that will be further discussed in the “Differential Diagnosis” section. PB - StatPearls Publishing CY - Treasure Island (FL) UR - https://www.unboundmedicine.com/medline/citation/32644422/StatPearls:_Epithelial_Downgrowth L2 - https://www.ncbi.nlm.nih.gov/books/NBK558996 DB - PRIME DP - Unbound Medicine ER -
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