Abstract
Purpose: :
To determine the possible involvement of soluble apoptosis and adhesion molecules in the pathogenesis of proliferative vitreoretinopathy (PVR) following reattachment surgery for rhegmatogenous retinal detachment (RRD).
Methods: :
A multiplex immunoassay was used to measure soluble Fas (sFas), sFas ligand (sFasL), soluble intercellular adhesion molecule-1 (sICAM-1), and soluble vascular cell adhesion molecule-1 (sVCAM-1) levels in 55 subretinal fluid samples collected during scleral buckling surgery for primary RRD. Seventeen patients who developed a redetachment due to postoperative PVR after reattachment surgery (PVR group) were compared with age-, sex-, and storage-time-matched RRD samples from 38 patients with an uncomplicated postoperative course (RRD group). Ten vitreous samples from patients with macular hole and ten vitreous samples from eye bank eyes served as additional controls.
Results: :
We found a 2- to 3-fold increase in levels of sFas, sFasL, sICAM-1, and sVCAM-1 in the PVR group as compared to the RRD group (P < 0.05 for all analytes), and a 5- to 20-fold increase in the PVR group as compared to the additional control groups (P < 0.001 for all analytes). Significant associations (P < 0.001) were found between sFas and both sICAM-1 (r = 0.84) and sVCAM-1 (r = 0.93) and between sFasL and both sICAM-1 (r = 0.82) and sVCAM-1 (r = 0.85). In addition, sFas, sFasL, and sVCAM-1 were significantly correlated (P < 0.05) with the extent and duration of retinal detachment. Both sFasL and sICAM-1 were not associated with preoperative PVR, whereas its correlations with sFas and sVCAM-1 were low (r = 0.31 and r = 0.32, respectively) (P < 0.05).
Conclusions: :
Sampling at a time close to the onset of primary RRD may provide clues as to which local factors may initiate the uncontrolled growth of cells that lead to PVR membrane formation. Our findings indicate that, at the time of primary retinal detachment surgery, an increased expression of the investigated soluble apoptosis and adhesion molecules is associated with the future development of PVR.
Keywords: retinal detachment • proliferative vitreoretinopathy • apoptosis/cell death