Department of Vitreo-Retinal Surgery, Center of Ophthalmology, University of Cologne, Cologne, Germany.
Br J Ophthalmol. 2013 Apr;97(4):450-3. doi: 10.1136/bjophthalmol-2012-302636. Epub 2013 Jan 26.
Aqueous flare as determined by laser flare photometry in the anterior chamber is a strong preoperative predictor for proliferative vitreoretinopathy (PVR) in patients with primary retinal detachment (RD). We analysed various cytokines in aqueous humour samples in relation to aqueous flare and postoperative PVR incidence in patients with RD.
Preoperatively, the aqueous flare of patients with RD was measured quantitatively with a laser flare metre and aqueous humour samples were collected and analysed for interferon γ, tumour necrosis factor α, monocyte chemoattractant protein (MCP)-1, interleukin (IL)-1β, IL-2, IL-4, IL-6, IL-8, vascular endothelial growth factor (VEGF)-A, platelet derived growth factor (PDGF)-aa, transforming growth factor (TGF)-β1, TGF-β2, TGF-β3, fibroblast growth factor (FGF)-aa and FGF-bb by multiplex fluorescent bead-based immunoassays. Three months after RD surgery patients were examined for PVR development.
Of 67 consecutive patients, 10 developed at least PVR grade C. Patients with flare values >15 pc/ms (n=20) and the 10 patients with postoperative PVR all had significantly elevated levels of IL-6, IL-8, MCP-1 and TGF-β1 in aqueous humour (p≤0.05). Levels of VEGF-A, PDGF-aa and TGF-β2 were not significantly changed. Other cytokines were below the detection threshold. Eight of the 10 patients (80%) with PVR had elevated flare values of >15 pc/ms and 8 of the 20 patients (40%) with flare >15 pc/ms developed PVR. The OR for PVR with flare values >15 pc/ms was 30.7 (p=0.0001).
Laser flare photometry allows simple risk estimation for later PVR development. Elevated laser flare values correspond to an altered profibrotic intraocular cytokine milieu. These factors therefore constitute promising targets for a prophylactic intervention.
前房激光闪烁光度法测定的房水闪辉是原发性视网膜脱离（RD）患者发生增生性玻璃体视网膜病变（PVR）的强烈术前预测指标。我们分析了 RD 患者房水中各种细胞因子与房水闪辉和术后 PVR 发生率的关系。
在 RD 患者术前，使用激光闪烁仪定量测量房水闪辉，采集房水样本并通过多聚荧光珠免疫分析检测干扰素γ、肿瘤坏死因子α、单核细胞趋化蛋白-1（MCP-1）、白细胞介素（IL）-1β、IL-2、IL-4、IL-6、IL-8、血管内皮生长因子（VEGF）-A、血小板衍生生长因子（PDGF）-aa、转化生长因子（TGF）-β1、TGF-β2、TGF-β3、成纤维细胞生长因子（FGF）-aa 和 FGF-bb。RD 手术后 3 个月，检查患者 PVR 发展情况。
在 67 例连续患者中，有 10 例至少发生了 PVR C 级。房水闪辉值>15 pc/ms（n=20）的患者和 10 例术后发生 PVR 的患者，IL-6、IL-8、MCP-1 和 TGF-β1 水平均显著升高（p≤0.05）。VEGF-A、PDGF-aa 和 TGF-β2 水平无明显变化。其他细胞因子低于检测阈值。在 10 例（80%）发生 PVR 的患者中有 8 例（80%）的房水闪辉值>15 pc/ms，在 20 例（40%）房水闪辉值>15 pc/ms 的患者中有 8 例（40%）发生 PVR。房水闪辉值>15 pc/ms 的 PVR 比值比（OR）为 30.7（p=0.0001）。
激光闪烁光度法可简单估计术后 PVR 发展的风险。升高的激光闪烁值与眼内促纤维化细胞因子环境的改变相对应。因此，这些因素构成了预防干预的有前途的靶点。
