The correlation between excessive vitreal protein levels, prostaglandin E2 levels, and the blood retinal barrier

Changes in vitreal protein and prostaglandin E2 (PGE2) concentrations, as well as chorioretinal in vitro PGE2 production, were studied in rabbit eyes following Neodymium (Nd):YAG laser retinal exposure. Laser exposure was associated with an enhanced vitreal PGE2 concentration throughout a two-week observation period, with highest levels on days 1 and 7 after exposure (a 5.3 and 4.7 increase above baseline, respectively). A transitory 50% elevation above baseline in vitreal protein levels was observed in the laser-exposed eyes during the second week after exposure. Laser exposure was also associated with an enhancement in the in vitro chorioretinal PGE2 production, which varied throughout the observation period, and was more pronounced during the first week after exposure, when levels were four times higher than baseline. Initially PGE2 vitreal levels were closely related to excessive in vitro production. However, during the second week after exposure, evidence of such correlation was lacking, but PGE2 vitreal levels coincided with a small increase in vitreal protein levels. It is suggested that disruption of the blood retinal barrier by the long-term exposure to mildly elevated vitreal PGE2 levels was accountable for protein leakage, which might have affected PGE2 removal mechanisms.     

Prolonged corticosteroid treatment exerts transient inhibitory effect on prostaglandin E2 release from rabbits' eyes

In humans, the retina and choroid (the photoreceptor and its vascular layers, respectively), are affected by an immunogenic inflammatory reaction--uveitis, associated with excessive levels of prostaglandin E2 (PGE2), and treated for prolonged periods with corticosteroids, known for their inhibitory effect on prostaglandins (PGs) production. In order to assess whether this drug retains its inhibitory effect during chronic use, we investigated the effect of long-term systemic administration of corticosteroids on PGE2 release by the choroid and retina of rabbits' eyes. We used eyes traumatized by laser irradiation, in which the inflammatory reaction is associated with an enhanced PGE2 in vitro release by the choroid-retina throughout a 2-week period; levels peaked on days 1 and 7 to values 2.2- and 5.5-fold, respectively, greater than baseline. Systemic corticosteroid administration to laser-exposed rabbits curtailed the excessive PGE2 release during the first post-laser week; later the amounts released progressively increased to levels 5.5-fold higher than baseline (day 14), whereas in the corresponding untreated laser group, levels were significantly lower. PGE2 tissue content on days 7 and 14 in steroid-treated and untreated laser groups were similarly elevated. We conclude that during prolonged systemic corticosteroids treatment the steroidal inhibitory effect on enhanced PGE2 formation by the retina-choroid of laser injured eyes is transient; it is evident during the early phase following drug administration, whereas later excessive PGE2 release is resumed.     

VEGF-Production by CCR2-Dependent Macrophages Contributes to Laser-Induced Choroidal Neovascularization

Age-related macular degeneration (AMD) is the most prevalent cause of blindness in the elderly, and its exsudative subtype critically depends on local production of vascular endothelial growth factor A (VEGF). Mononuclear phagocytes, such as macrophages and microglia cells, can produce VEGF. Their precursors, for example monocytes, can be recruited to sites of inflammation by the chemokine receptor CCR2, and this has been proposed to be important in AMD. To investigate the role of macrophages and CCR2 in AMD, we studied intracellular VEGF content in a laser-induced murine model of choroidal neovascularisation. To this end, we established a technique to quantify the VEGF content in cell subsets from the laser-treated retina and choroid separately. 3 days after laser, macrophage numbers and their VEGF content were substantially elevated in the choroid. Macrophage accumulation was CCR2-dependent, indicating recruitment from the circulation. In the retina, microglia cells were the main VEGF⁺ phagocyte type. A greater proportion of microglia cells contained VEGF after laser, and this was CCR2-independent. On day 6, VEGF-expressing macrophage numbers had already declined, whereas numbers of VEGF⁺ microglia cells remained increased. Other sources of VEGF detectable by flow cytometry included in dendritic cells and endothelial cells in both retina and choroid, and Müller cells/astrocytes in the retina. However, their VEGF content was not increased after laser. When we analyzed flatmounts of laser-treated eyes, CCR2-deficient mice showed reduced neovascular areas after 2 weeks, but this difference was not evident 3 weeks after laser. In summary, CCR2-dependent influx of macrophages causes a transient VEGF increase in the choroid. However, macrophages augmented choroidal neovascularization only initially, presumably because VEGF production by CCR2-independent eye cells prevailed at later time points. These findings identify macrophages as a relevant source of VEGF in laser-induced choroidal neovascularization but suggest that the therapeutic efficacy of CCR2-inhibition might be limited.     

Vitreal dihydroxyphenylacetic acid (DOPAC) as an index of retinal dopamine release

Dopamine is generally accepted as a major neurotransmitter associated with light-adaptive processes in the retina. However, little is known about its precise release pattern in vivo, largely due to the lack of an unambiguous method for the determination of dopamine release. We have found that vitreal levels of dihydroxyphenylacetic acid (DOPAC) reflect the rate of dopamine release in chickens. Blocking re-uptake with nomifensine significantly lowered vitreal DOPAC and retinal dopamine, confirming the retinal origin and reliance of vitreal DOPAC on intact re-uptake mechanisms. Further, inhibition of monoamine oxidase with pargyline reduced vitreal as well as retinal DOPAC levels, confirming that the DOPAC detected is generated by monoamine oxidase. Finally, we found that DOPAC diffused freely into and out of isolated vitreous bodies and we found the vitreous to be metabolically inert with respect to DOPAC, supporting the idea that vitreal levels of DOPAC are consequential to the retinal metabolism of dopamine. Exposure to light, which is known to increase retinal dopamine release, readily increased vitreal DOPAC levels. The accumulation of DOPAC in the vitreous over 6 h light fitted a mathematical model of DOPAC accumulation based on zero-order influx (proportional to dopamine release rates) and diffusion driven, first-order efflux.     

Alpha melanocyte stimulating hormone (alpha-MSH) enhances eicosanoid production by bovine retinal pigment epithelium.

Explants of bovine eyes consisting of retina, with its underlying choroid and sclera (termed retinal explants) were maintained in organ culture in the absence or presence of alpha-melanocyte stimulating hormone (alpha-MSH) for up to 19 days. The conditioned media was collected twice a week and assayed for the following eicosanoids, prostaglandin E2 (PGE2) and prostacyclin. The addition of alpha-MSH to the incubation media resulted in a 1.5 fold enhancement in the production of both PGE2 and prostacyclin. This stimulatory effect diminished after 11 days. Additionally, the three tissue components comprising the retinal explants i.e. 1. neural retina 2. retinal pigment epithelium (RPE) with its underlying vascular layer (choroid) and 3. scleral tissue were separated and incubated in the presence or absence of alpha-MSH. Hormone treatment caused an enhanced eicosanoid production by RPE tissue alone, while its production by the neuronal retina and sclera was reduced or unaffected respectively. This demonstrates that the RPE layer is the source for the alpha-MSH induced eicosanoid production observed in the whole retinal explant. Our findings demonstrate, for the first time that alpha-MSH can stimulate prostaglandin production by RPE maintained in organ culture.     

578.2 nm激光照射对兔视网膜的损伤效应研究

研究578.2 nm激光照射对兔视网膜的作用特点,以新西兰白兔5只10眼为实验对象,铜蒸汽激光(578.2 nm)通过裂隙灯照射兔视网膜后极部,照射时间为100 s,光斑直径为2 mm,照射剂量分别为60 J/cm2、80 J/cm2、100 J/cm2、120 J/cm2、160 J/cm2、200 J/cm2,每组4个光斑。照后1 h及24 h进行眼底照相及光镜观察。照光后可见,随激光功率密度的增加,兔视网膜的损伤也逐渐加重,并且照后24 h的损伤要重于照后1h。80 J/cm2和60 J/cm2在照后1 h和24 h均未发现明显改变。578.2 nm激光照射白兔后的主要病理学改变位于脉络膜。因此,以578.2 nm激光作为光动力治疗眼底疾病的光源时,照射剂量不宜超过80 J/cm2。     

Biological role of lutein in the light-induced retinal degeneration

Lutein, a xanthophyll of a carotenoid, is anticipated as a therapeutic product to prevent human eye diseases. However, its biological mechanism is still unclear. Here, we show the molecular mechanism of lutein's effect to reduce photodamage of the retina. We analyzed the light-exposed retinas of Balb/c mice given lutein-supplemented or normal diet. Visual function was measured by electroretinogram, and histological changes were observed. Immunohistochemical and immunoblot analyses were performed to analyze molecular mechanism. The reactive oxygen species induced in the retina was evaluated by fluorescent probes. In the mice after light exposure, reduction of a-wave and b-wave amplitudes in electroretinogram, indicating visual impairment, and thinning of the photoreceptor cell layer owing to apoptosis were both attenuated by lutein diet. Interestingly, γ-H2AX, a marker for double-strand breaks (DSBs) in DNA, was up-regulated in the photoreceptor cells after light exposure, but this increase was attenuated by lutein diet, suggesting that DSBs caused by photodamage contributed to the photoreceptor cell death and that this change was suppressed by lutein. Moreover, the expression of eyes absent (EYA), which promotes DNA repair and cell survival, was significantly up-regulated with lutein diet in the light-exposed retina. Therefore, lutein induced EYA for DNA repair, which could suppress DNA damage and photoreceptor cell apoptosis. Lutein reduced light-induced oxidative stress in the retina, which might contribute to promote DNA repair. The lutein-supplemented diet attenuated light-induced visual impairment by protecting the photoreceptor cells' DNA.     

Histopathological analysis of UV-B irradiated retina by Cavia Coba'ya and with protection of transmission light lambda 550-600 nm

In 14 experimental Cavia Coba'ya eyes were irradiated with UV-B light, lambda 312 nm, 25 J/cm2 in 15 minute exposure. Including the transmission of light through optical media: cornea, lens, humor aqueous and vitreous body, and pupil surface of 7 mm2, we can calculate that in these conditions retina can be really irradiated with 10 J/cm2. The half number of Cavia Coba'ya was simultaneously irradiated with visible light, lambda of 550-600 nm (1000 Lx). Control group was 5 Cavia Coba'ya. Two months after irradiation, eyes were enucleated and fixed in 4% formaldehyde. Histopathological findings showed alterations of all retinal layers: loss of ganglion cells, axons, reduction of photoreceptors, vacuolar degeneration and hyperplasia of retinal pigment epithelium. In the second group of irradiance, the eyes with visible light lambda 550-600 nm, all retinal alterations were in 50% decreased.     

Lack of collagen XVIII/endostatin results in eye abnormalities

Mice lacking collagen XVIII and its proteolytically derived product endostatin show delayed regression of blood vessels in the vitreous along the surface of the retina after birth and lack of or abnormal outgrowth of retinal vessels. This suggests that collagen XVIII/endostatin is critical for normal blood vessel formation in the eye. All basement membranes in wild-type eyes, except Descemet's membrane, showed immunogold labeling with antibodies against collagen XVIII. Labeling at sites where collagen fibrils in the vitreous are connected with the inner limiting membrane and separation of the vitreal matrix from the inner limiting membrane in mutant mice indicate that collagen XVIII is important for anchoring vitreal collagen fibrils to the inner limiting membrane. The findings provide an explanation for high myopia, vitreoretinal degeneration and retinal detachment seen in patients with Knobloch syndrome caused by loss-of-function mutations in collagen XVIII.     

670nm Photobiomodulation as a Novel Protection against Retinopathy of Prematurity: Evidence from Oxygen Induced Retinopathy Models

Introduction

To investigate the validity of using 670nm red light as a preventative treatment for Retinopathy of Prematurity in two animal models of oxygen-induced retinopathy (OIR).

Materials and Methods

During and post exposure to hyperoxia, C57BL/6J mice or Sprague-Dawley rats were exposed to 670nm light for 3 minutes a day (9J/cm²). Whole mounted retinas were investigated for evidence of vascular abnormalities, while sections of neural retina were used to quantify levels of cell death using the TUNEL technique. Organs were removed, weighed and independent histopathology examination performed.

Results

670nm light reduced neovascularisation, vaso-obliteration and abnormal peripheral branching patterns of retinal vessels in OIR. The neural retina was also protected against OIR by 670nm light exposure. OIR-exposed animals had severe lung pathology, including haemorrhage and oedema, that was significantly reduced in 670nm+OIR light-exposed animals. There were no significance differences in the organ weights of animals in the 670nm light-exposed animals, and no adverse effects of exposure to 670nm light were detected.

Discussion

Low levels of exposure to 670nm light protects against OIR and lung damage associated with exposure to high levels of oxygen, and may prove to be a non-invasive and inexpensive preventative treatment for ROP and chronic lung disease associated with prematurity.     

On the structure of retina of a fresh-water mullet, Rhinomugil corsula (Mugilidae, Pisces).

1. The structure of the eye-ball of Rhimomugil corsula has been described. 2. A mid-horizontal ridge (band) along the vitreal surface of the retina in each eye of R. corsula has been observed which divides the retina into a superior and an inferior hemispheres probably adapted for aquatic (dim-light vision) and aerial (bright-light vision) vision. 3. The superior hemisphere has been provided with poorly developed choroid gland and scarce pigment in the pigment epithelial cells. 4. The visual cell layer in the retina of the superior hemisphere contains both single and twin cones. They are alternately arranged in parallel rows. 5. The external and internal limiting membranes have been observed in both the hemispheres under light microscope. 6. The outer plexiform layer of the superior hemisphere contains many horizontal cells arranged into four distinct rows. 7. The inferior hemisphere has a well developed choroid gland, and dense pigment in the pigment epithelial cells.     

Melanin protects choroidal blood vessels against light toxicity

Low ocular pigmentation and high long-term exposure to bright light are believed to increase the risk of developing age-related macular degeneration (ARMD). To investigate the role of pigmentation during bright light exposure, cell damage in retinae and choroids of pigmented and non-pigmented rats were compared. Pigmented Long Evans (LE) rats and non-pigmented (albino) Wistar rats were exposed to high intensity visible light from a cold light source with 140,000 lux for 30 min. Control animals of both strains were not irradiated. The animals had their pupils dilated to prevent light absorbance by iris pigmentation. 22 h after irradiation, the rats were sacrificed and their eyes enucleated. Posterior segments, containing retina and choroid, were prepared for light and electron microscopy. Twenty different sections of specified and equal areas were examined in every eye. In albino rats severe retinal damage was observed after light exposure, rod outer segments (ROS) were shortened and the thickness of the outer nuclear layer (ONL) was significantly diminished. Choriocapillaris blood vessels were obstructed. In wide areas the retinal pigment epithelium (RPE) was absent in albino rats after irradiation. In contrast, LE rats presented much less cell damage in the RPE and retina after bright light exposure, although intra-individual differences were observed. The thickness of the ONL was almost unchanged compared to controls. ROS were shortened in LE rats, but the effect was considerably less than that seen in the albinos. Only minimal changes were found in choroidal blood vessels of pigmented rats. The RPE showed certain toxic damage, but cells were not destroyed as in the non-pigmented animals. The number of melanin granules in the RPE of LE rats was reduced after irradiation. Ocular melanin protects the retina and choroid of pigmented eyes against light-induced cell toxicity. Physical protection of iris melanin, as possible in eyes with non-dilated pupils, does not seem to play a major role in our setup. Biochemical mechanisms, like reducing oxidative intracellular stress, are more likely to be responsible for melanin-related light protection in eyes with dilated lens aperture.     

Diurnal patterns of dopamine release in chicken retina

The retinal dopaminergic system appears to play a major role in the regulation of global retinal processes related to light adaptation. Although most reports agree that dopamine release is stimulated by light, some retinal functions that are mediated by dopamine exhibit circadian patterns of activity, suggesting that dopamine release may be controlled by a circadian oscillator as well as by light. Using the accumulation of the dopamine metabolite dihydroxyphenylacetic acid (DOPAC) in the vitreous as a measure of dopamine release rates, we have investigated the balance between circadian- and light control over dopamine release. In chickens held under diurnal light:dark conditions, vitreal levels of DOPAC showed daily oscillations with the steady-state levels increasing nine-fold during the light phase. Kinetic analysis of this data indicates that apparent dopamine release rates increased almost four-fold at the onset of light and then remained continuously elevated throughout the 12h light phase. In constant darkness, vitreal levels of DOPAC displayed circadian oscillations, with an almost two-fold increase in dopamine release rates coinciding with subjective dawn/early morning. This circadian rise in vitreal DOPAC could be blocked by intravitreal administration of melatonin (10 nmol), as predicted by the model of the dark-light switch where a circadian fall in melatonin would relieve dopamine release of inhibition and thus be responsible for the slight circadian increase in dopamine release. The increase in vitreal DOPAC in response to light, however, was only partially suppressed by melatonin. The activity of the dopaminergic amacrine cell in the chicken retina thus appears to be dominated by light-activated input.     

Radioautographic study on DNA synthesis of the retina and retinal pigment epithelium of developing mouse embryos.

We report the changes of proliferative activity of the retina and retinal pigment epithelium (RPE) of mouse embryos by detecting cells in the S-phase by light microscopic radioautography using 3H-thymidine. The eyes germs of mouse embryos at the embryonic days 9.5 (E 9.5), E 11.5, E 13.0, E 15.5, E 18.5 of gestational ages, were used for this experiment. Small pieces of the ocular tissues were labelled with 3H-TDR in vitro and light microscopic radioautographs were prepared. The labeling indices of the respective regions of tissues were calculated. Both tissues of retina and RPE showed high percentages of labeling indices from 10% to 50% through the developmental stages. The labeling indices of both tissues in earlier stages were generally higher than those of later stages, and gradually decreased in the later stages. However, the retina and RPE showed different courses of the changes of labeling indices respectively during the embryonic development. In the retina, the labeling indices in the vitreal portions were more than those in the scleral portions during the earlier developmental stages. However, in the later stages, the indices of scleral portions were more than those in the vitreal portions. Comparing the three regions of retina, the labeling indices of the anterior regions were generally higher than those of the equatorial and posterior regions, especially in the vitreal portion. Remarkable differences among three regions were not found in the scleral portion. In the RPE, the labeling indices gradually increased in the anterior region, but decreased in the equatorial and the posterior regions through all the developmental stages. The proliferation of both retina and RPE in the central region occurred earlier than those of the peripheral region.     

Liquid chromatography electrospray ionization mass spectrometry analysis of the ocular metabolites from a short interfering RNA duplex

The ocular metabolism of an siRNA duplex, SIRNA-027, was examined by ion-pair reversed-phase liquid chromatography (IP-RP-LC) coupled to electrospray ionization mass spectrometry (ESI-MS). The RNA duplex was injected intraocularly into the eyes of New Zealand white rabbits. Rabbits were sacrificed at different timepoints and the vitreous and retina/choroid tissue analyzed for siRNA by IP-RP-LC-MS. The method used a hexafluoroisopropanol (HFIP)/triethylamine (TEA) ion-pairing buffer with a methanol gradient. Using electrospray ionization, the duplex was preserved in the gas phase for analysis by a triple quadrupole mass spectrometer. With this methodology metabolites from rabbit ocular vitreous humor and retina/choroid tissue were identified and a pattern of siRNA degradation was established. Results showed that the duplex was metabolized predominantly from one end. This end of the siRNA duplex was calculated to have the weakest binding energy of the two ends indicating that the ability of the siRNA to split into single strands is a factor in its degradation.     

Ophtalmoscopic examination in critically ill non-neutropenic patients: Candida endophtalmitis

Invasive Candida (IC) infection is the most common cause of endogenous endophthalmitis. Ocular candidiasis develops within three days and at least two weeks of fungemia. There are two characteristic ocular signs: Candida chorioretinitis defined as retina and choroid lesions without vitreal involvement, and Candida endophthalmitis defined as chorioretinitis with extension into the vitreous with characteristic fluffy balls. The most common initial visual symptoms are blurred vision and floaters. Amphotericin B, fluconazole and voriconazole are effective in the treatment of chorioretinitis; however, when vitreous is involved vitrectomy seems necessary. Early antifungal systemic treatment at first evidence of infection in patients at risk of IC, appears to decrease dramatically the incidence of endogenous fungal endophthalmitis, probably healing minimal chorioretinal infections. Routine ophthalmoscopic examination seems of little value in patients with positive blood culture, with early implementation of antifungal treatment, without symptoms of ocular infection and without impairment of the level of consciousness during the episode. However, periodic ophthalmoscopic examination should be performed in children with candidemia and critically ill patients with documented deep Candida infection.     

Tubedown-1 in remodeling of the developing vitreal vasculature in vivo and regulation of capillary outgrowth in vitro

Tubedown-1 (tbdn-1) is a mammalian homologue of the N-terminal acetyltransferase subunit NAT1 of Saccharomyces cerevisiae and copurifies with an acetyltransferase activity. Tbdn-1 expression in endothelial cells becomes downregulated during the formation of capillary-like structures in vitro and is regulated in vivo in a manner which suggests a functional role in dampening blood vessel development. Here we show that tbdn-1 is expressed highly in the vitreal vascular network (tunica vasculosa lentis and vasa hyaloidea propria) during the pruning and remodeling phases of this transient structure. The vitreal blood vessels of mice harboring a targeted inactivation of TGF-beta2 fail to remodel and abnormally accumulate, a phenomenon reminiscent of the ocular pathology resembling persistent fetal vasculature (PFV) in humans. Since suppression of normal tbdn-1 expression has been previously observed in retinal vessel proliferation, we analyzed vitreal vascular changes and tbdn-1 expression in TGF-beta2(-/-) eyes. The nuclei of vitreal vessel endothelial cells in TGF-beta2(-/-) eyes express proliferating cell nuclear antigen (PCNA) and exhibit increased levels of active (P42/44)mitogen-activated protein kinase (phospho-(P42/44)MAPK), characteristics consistent with proliferative endothelial cells. In contrast to normal vitreal vessels, collagen IV expression exhibited a disorganized pattern in the TGF-beta2(-/-) vitreal vessels, suggesting vessel disorganization and possibly a breakdown of vessel basal laminae. Moreover, vitreal vessels of TGF-beta2(-/-) mice lack expression of pericyte markers (CD13, alpha smooth muscle actin) and show ultrastructural changes consistent with pericyte degeneration. The accumulating vitreal blood vessels of TGF-beta2(-/-) mice, while maintaining expression of the endothelial marker von Willebrand Factor, show a significant decrease in the expression of tbdn-1. We addressed the functional role of tbdn-1 in the regulation of vitreal blood vessels using an in vitro model of choroid-retina capillary outgrowth. Clones of the RF/6A fetal choroid-retina endothelial cell line showing suppression of tbdn-1 levels after overexpression of an antisense TBDN-1 cDNA display a significant increase in the formation of capillary-like structures in vitro compared with controls. These findings suggest that tbdn-1 inhibits capillary-like formation in vitro and may serve to dampen vitreal blood vessel formation preceding the regression of the vitreal vasculature during development. Our results also suggest that tbdn-1 may participate with TGF-beta2 in regulating normal development of the vitreal vasculature.     

Blue light filtering intraocular lenses in phacoemulsification cataract surgery

Blue light can damage retina and cause age related macular degeneration. After cataract surgery and lens removal retina stays unprotected. Blue light filtering intraocular lenses (IOL) increase protection of the retina. In our prospective study we investigated clinical results after bilateral implantation of Acrysof Natural IOL to 30 patients (N = 60 eyes). In a control group (N = 60 eyes, 30 patients), standard acrysof IOL was implanted bilaterally. Uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA) and Nd YAG laser capsulotomy rate were measured and compared with control group. Subjective patient's satisfaction and subjective colour perception were also investigated. There was no significant difference in UCVA, BCVA and Nd YAG laser capsulotomy rate between the two groups. High patient's satisfaction was noticed (96.7% of patients would implant Acrysof Natural IOL again). Acrysof Natural IOL enables good visual acuity VA, low rate of Nd YAG laser capsulotomy and high patient's satisfaction without colour perception disturbances.     

玻璃体视网膜手术治疗先天性视网膜劈裂及其并发症的临床疗效

目的:评价玻璃体视网膜手术治疗先天性视网膜劈裂及其并发症的临床疗效。方法:选择2009年1月-2012年1月于我院进行玻璃体视网膜手术的先天性视网膜劈裂患者30例(42只眼),患者均接受了闭合式睫状体经扁平部三切口入路保留晶状体的玻璃体切割手术,并分析其术前及术后情况。结果:先天性视网膜劈裂患者中发生孔源性视网膜脱离19眼,牵拉性视网膜脱离8眼,玻璃体积血10眼,同时伴有视网膜脱离和玻璃体积血有5眼;在末次随访时视力提高者有36只眼,占85.71%,无提高者有6只眼,占14.29%;术前平均视力为(0.15±0.09),末次随访时平均视力提高至(0.31±0.16),两者平均视力差异具有统计学意义(t=5.649,P0.001);42只眼视网膜解剖结构复位良好,视网膜平伏;OCT检查结果显示,末次随访时黄斑劈裂平均面积(0.22±0.18)mm2,与术前黄斑劈裂平均面积(1.07±0.52)mm2比较,差异有统计学意义(t=10.011,P0.001),黄斑微囊样改变有改善;随访期间5只眼出现并发症,占11.90%,其中2眼术后发生PVR且伴牵拉性视网膜脱离,2只眼发生白内障,1只眼出现玻璃体积血,术后视网膜解剖均复位良好。结论:玻璃体视网膜手术可以帮助患者进行视网膜解剖复位及提高其先天性视网膜劈裂患者视功能,具有良好的临床疗效。     

Increased Expression of Angiogenic and Inflammatory Proteins in the Vitreous of Patients with Ischemic Central Retinal Vein Occlusion

BackgroundCentral retinal vein occlusion (CRVO) is a common disease characterized by a disrupted retinal blood supply and a high risk of subsequent vision loss due to retinal edema and neovascular disease. This study was designed to assess the concentrations of selected signaling proteins in the vitreous and blood of patients with ischemic CRVO.MethodsVitreous and blood samples were collected from patients undergoing surgery for ischemic CRVO (radial optic neurotomy (RON), n = 13), epiretinal gliosis or macular hole (control group, n = 13). Concentrations of 40 different proteins were determined by an ELISA-type antibody microarray.ResultsExpression of proteins enriched in the vitreous (CCL2, IGFBP2, MMP10, HGF, TNFRSF11B (OPG)) was localized by immunohistochemistry in eyes of patients with severe ischemic CRVO followed by secondary glaucoma. Vitreal expression levels were higher in CRVO patients than in the control group (CRVO / control; p < 0.05) for ADIPOQ (13.6), ANGPT2 (20.5), CCL2 (MCP1) (3.2), HGF (4.7), IFNG (13.9), IGFBP1 (14.7), IGFBP2 (1.8), IGFBP3 (4.1), IGFBP4 (1.7), IL6 (10.8), LEP (3.4), MMP3 (4.3), MMP9 (3.6), MMP10 (5.4), PPBP (CXCL7 or NAP2) (11.8), TIMP4 (3.8), and VEGFA (85.3). In CRVO patients, vitreal levels of CCL2 (4.2), HGF (23.3), IGFBP2 (1.23), MMP10 (2.47), TNFRSF11B (2.96), and VEGFA (29.2) were higher than the blood levels (vitreous / blood, p < 0.05). Expression of CCL2, IGFBP2, MMP10, HGF, and TNFRSF11B was preferentially localized to the retina and the retinal pigment epithelium (RPE).ConclusionProteins related to hypoxia, angiogenesis, and inflammation were significantly elevated in the vitreous of CRVO patients. Moreover, some markers known to indicate atherosclerosis may be related to a basic vascular disease underlying RVO. This would imply that local therapeutic targeting might not be sufficient for a long term therapy in a systemic disease but hypothetically reduce local changes as an initial therapeutic approach.