Yeh Po-Ting, Yang Chung-May, Huang Jen-Shang, Chien Chiang-Ting, Yang Chang-Hao, Chiang Yi-Hui, Shih Yung-Feng
Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan.
Ophthalmology. 2008 Apr;115(4):734-737.e1. doi: 10.1016/j.ophtha.2007.05.041. Epub 2008 Jan 4.
To investigate vitreous levels of reactive oxygen species (ROS) in patients with proliferative diabetic retinopathy (PDR) and analyze ROS levels among different groups of PDR patients.
Retrospective case-control study.
Thirty-nine eyes of 39 patients with PDR and 16 eyes of 16 non-PDR patients (control group) that underwent primary vitrectomy for complications of PDR and other conditions (control group), with a follow-up time > or = 12 months.
Proliferative diabetic retinopathy patients were classified into 3 groups according to the extent of fibrovascular proliferation: (1) no or focal adhesions at < or =3 sites (n = 17); (2) > or =1 broad adhesions or vitreous-retinal adhesions around disc, macula, and arcade (n = 12); and (3) vitreous-retinal attachment extending to the periphery or no posterior vitreous detachment with or without retinal detachment (RD) (n = 10). The control group (n = 16) contained non-PDR patients. Vitreous samples were obtained during measurement of vitrectomy and vitreous levels of ROS by luminol-enhanced chemiluminescence assay.
Reactive oxygen species levels were recorded as mean (+/- standard deviation) chemiluminescence counts per 10 seconds. Correlations of vitreous levels of ROS among the 3 PDR groups and anatomic prognosis were evaluated. Multiple linear regression analysis of selective potential risk factors was performed to investigate the main determinants of ROS levels.
Vitreous ROS levels were significantly higher in patients with PDR (125.76+/-351.72 chemiluminescence counts per 10 seconds) than in control patients (0.37+/-0.72 chemiluminescence counts per 10 seconds; P<0.0001). Reactive oxygen species levels were 1.86+/-1.63 (group 1), 24.47+/-22.68 (group 2), and 457.94+/-597.01 (group 3); the difference among groups was significant (P = 0.001). Regression analysis indicated that only patient grouping (according to the severity of fibrovascular proliferation) had a strong dependent association with ROS levels (P = 0.001). Final anatomic results revealed that recurrent untreatable RD occurred in 3 patients of group 3, who also had the highest ROS levels.
Reactive oxygen species levels were significantly elevated in the vitreous fluid of PDR patients, and patients with a more advanced clinical PDR appearance had higher ROS levels. These findings suggest an association between ROS and the pathogenesis of PDR. Reactive oxygen species might be correlated with PDR severity.
研究增殖性糖尿病视网膜病变（PDR）患者玻璃体内活性氧（ROS）水平，并分析不同组PDR患者的ROS水平。
回顾性病例对照研究。
39例PDR患者的39只眼以及16例非PDR患者（对照组）的16只眼，这些患者因PDR及其他疾病并发症接受了一期玻璃体切除术，随访时间≥12个月。
根据纤维血管增殖程度将增殖性糖尿病视网膜病变患者分为3组：（1）在≤3个部位无或仅有局灶性粘连（n = 17）；（2）在视盘、黄斑和视网膜弓周围有≥1处广泛粘连或玻璃体视网膜粘连（n = 12）；（3）玻璃体视网膜附着延伸至周边或无玻璃体后脱离伴或不伴视网膜脱离（RD）（n = 10）。对照组（n = 16）为非PDR患者。在玻璃体切除术中获取玻璃体样本，采用鲁米诺增强化学发光法检测玻璃体内ROS水平。
将活性氧水平记录为每10秒的平均（±标准差）化学发光计数。评估3组PDR患者玻璃体内ROS水平与解剖学预后的相关性。对选择性潜在危险因素进行多元线性回归分析，以研究ROS水平的主要决定因素。
PDR患者玻璃体内ROS水平（每10秒125.76±351.72化学发光计数）显著高于对照组患者（每10秒0.37±0.72化学发光计数；P<0.0001）。活性氧水平在第1组为1.86±1.63，第2组为24.47±22.68，第3组为457.94±597.01；组间差异具有统计学意义（P = 0.001）。回归分析表明，仅患者分组（根据纤维血管增殖严重程度）与ROS水平有强相关性（P = 0.001）。最终解剖结果显示，第3组有3例患者发生复发性不可治疗的视网膜脱离，这些患者的ROS水平也最高。
PDR患者玻璃体内活性氧水平显著升高，临床PDR表现越严重的患者ROS水平越高。这些发现提示ROS与PDR的发病机制之间存在关联。活性氧可能与PDR严重程度相关。
