细胞间黏附分子1（ICAM-1）的玻璃体水平作为增殖性玻璃体视网膜病变的风险指标。
Vitreous levels of intercellular adhesion molecule 1 (ICAM-1) as a risk indicator of proliferative vitreoretinopathy.
作者信息
Limb G A, Chignell A H
机构信息
Department of Pathology, Moorfields Eye Hospital and Institute of Ophthalmology, London.
出版信息
Br J Ophthalmol. 1999 Aug;83(8):953-6. doi: 10.1136/bjo.83.8.953.
AIM
To investigate whether high vitreous levels of the soluble intercellular adhesion molecule 1 (sICAM-1) may be related to clinical risk factors of proliferative vitreoretinopathy (PVR) and whether their measurement may serve as an additional risk indicator of this complication in eyes with rhegmatogenous retinal detachment (RRD).
METHODS
Levels of sICAM-1 were measured by enzyme linked immunosorbent assays (ELISA) in vitreous from 36 eyes with RRD clinically considered to be at high risk of developing PVR (large retinal breaks, vitreous haemorrhage, long standing RRD, and previous vitreoretinal surgery). Levels of sICAM-1 in this group were compared with those in vitreous from 31 eyes with RRD without clinical risk factors for PVR, 32 eyes with established PVR and 10 eyes with macular holes.
RESULTS
Vitreous from eyes with RRD at high risk of developing PVR contained significantly higher levels of sICAM-1 (range 6.1-97.7 ng/ml; Mann-Whitney test, p=0.0002) than those from eyes with RRD at low risk of developing this complication (range 4.8-17.7 ng/ml). Vitreous sICAM-1 levels in eyes with RRD at high risk of developing PVR were significantly lower than in eyes with established PVR (p=0.037), but higher than in eyes with macular holes (p <0.0001). Levels of sICAM-1 >/=15 ng/ml (3 x median of the levels present in control eyes) provide a useful cut off point for a highly specific test (96.7%) with high positive (91.6%) and negative (96.7%) predictive values, despite a relatively low sensitivity (30. 5%).
CONCLUSIONS
The present findings suggest that laboratory measurement of sICAM-1 levels in vitreous from eyes with RRD may constitute an additional factor for identifying patients at high risk of PVR. Hence, determination of sICAM-1 levels may aid in the monitoring of patients likely to develop this complication and in the identification of patients who may benefit from adjuvant anti-inflammatory therapy.
目的
研究玻璃体中可溶性细胞间黏附分子1（sICAM-1）水平升高是否与增殖性玻璃体视网膜病变（PVR）的临床危险因素相关，以及检测sICAM-1水平是否可作为孔源性视网膜脱离（RRD）患者发生该并发症的额外风险指标。
方法
采用酶联免疫吸附测定（ELISA）法检测36例临床认为发生PVR风险高的RRD患者（大的视网膜裂孔、玻璃体出血、RRD病程长及既往有玻璃体视网膜手术史）玻璃体中sICAM-1水平。将该组患者玻璃体中sICAM-1水平与31例无PVR临床危险因素的RRD患者、32例已发生PVR患者及10例黄斑裂孔患者玻璃体中sICAM-1水平进行比较。
结果
发生PVR风险高的RRD患者玻璃体中sICAM-1水平（范围6.1 - 97.7 ng/ml；Mann-Whitney检验，p = 0.0002）显著高于发生该并发症风险低的RRD患者玻璃体中sICAM-1水平（范围4.8 - 17.7 ng/ml）。发生PVR风险高的RRD患者玻璃体中sICAM-1水平显著低于已发生PVR患者（p = 0.037），但高于黄斑裂孔患者（p < 0.0001）。sICAM-1水平≥15 ng/ml（对照眼水平中位数的3倍）为一项高特异性检测（96.7%）提供了有用的截断点，其阳性预测值（91.6%）和阴性预测值（96.7%）较高，尽管敏感性相对较低（30.5%）。
结论
目前的研究结果表明，检测RRD患者玻璃体中sICAM-1水平可能是识别PVR高危患者的一个额外因素。因此，测定sICAM-1水平可能有助于监测可能发生该并发症的患者，并有助于识别可能从辅助性抗炎治疗中获益的患者。
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