Troger J, Kremser B, Irschick E, Göttinger W, Kieselbach G
Department of Ophthalmology and Optometry, University of Innsbruck, Austria.
Graefes Arch Clin Exp Ophthalmol. 1998 Dec;236(12):900-3. doi: 10.1007/s004170050178.
We detected aqueous humor levels of substance P in patients with various grades of proliferative vitreoretinopathy and with uncomplicated rhegmatogenous retinal detachment. To evaluate the significance of the concentration of substance P at the time of surgery for retinal detachment for subsequent development of proliferative vitreoretinopathy, the latter patients also underwent fundoscopic control examination.
Using a highly specific and sensitive radioimmunoassay, the content of substance P in fresh samples of aqueous humor obtained by paracentesis was determined both in cataract controls and in patients with uncomplicated rhegmatogenous retinal detachment and with various grades of proliferative vitreoretinopathy. Retinal detachment patients underwent fundoscopic control examination 6 months after surgical reattachment.
The mean concentration of substance P in cataract controls was 40.3 (+22.4) fmol/mg protein, in the retinal detachment group 61.9 (+/-13.9) fmol/mg protein and in proliferative vitreoretinopathy 335.2 (+/-24.8) fmol/mg protein, but no correlation between levels of the peptide and various grades of the disease was observed. Already at surgery for retinal detachment three in four patients who developed proliferative vitreoretinopathy presented with levels of substance P in the range of the disease.
The concentration of substance P in aqueous humor is significantly high in patients with proliferative vitreoretinopathy in whom surgery is indicated. Furthermore, elevation of the peptide in retinal detachment that originates most obviously from a neurogenic mechanism may indicate initiation of processes associated with proliferative vitreoretinopathy, thus representing an indicator of significant risk for evolution of the disease at a very early time.
我们检测了不同程度增生性玻璃体视网膜病变患者以及单纯孔源性视网膜脱离患者房水中P物质的水平。为了评估视网膜脱离手术时P物质浓度对增生性玻璃体视网膜病变后续发展的意义，后一组患者也接受了眼底检查。
使用高度特异且灵敏的放射免疫分析法，测定了白内障对照组、单纯孔源性视网膜脱离患者以及不同程度增生性玻璃体视网膜病变患者经前房穿刺获取的新鲜房水样本中P物质的含量。视网膜脱离患者在手术复位6个月后接受眼底检查。
白内障对照组中P物质的平均浓度为40.3（±22.4）fmol/mg蛋白质，视网膜脱离组为61.9（±13.9）fmol/mg蛋白质，增生性玻璃体视网膜病变组为335.2（±24.8）fmol/mg蛋白质，但未观察到该肽水平与疾病不同程度之间存在相关性。在视网膜脱离手术时，四分之三发生增生性玻璃体视网膜病变的患者其P物质水平已处于该疾病范围内。
在需要手术治疗的增生性玻璃体视网膜病变患者中，房水中P物质的浓度显著升高。此外，视网膜脱离时该肽的升高最明显源于神经源性机制，这可能表明与增生性玻璃体视网膜病变相关的过程已启动，从而在疾病早期就代表了疾病进展的重大风险指标
